Phosphinic amide prodrugs of tenofovir

ABSTRACT

Compounds of Formula I: I and their pharmaceutically acceptable salts are useful for the inhibition of HIV reverse transcriptase. The compounds may also be useful for the prophylaxis or treatment of infection by HIV and in the prophylaxis, delay in the onset or progression, and treatment of AIDS. The compounds and their salts can be employed as ingredients in pharmaceutical compositions, optionally in combination with other antiviral agents, immunomodulators, antibiotics or vaccines.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a U.S. National Phase application under 35 U.S.C. § 371 of PCT Application No. PCT/US2019/041757, filed Jul. 15, 2019, which claims priority under 35 U.S.C. § 119(e) from provisional Application No. 62/700,691, filed Jul. 19, 2018.

BACKGROUND OF THE INVENTION

The retrovirus designated human immunodeficiency virus (HIV), particularly the strains known as HIV type-1 (HIV-1) and type-2 (HIV-2), have been etiologically linked to the immunosuppressive disease known as acquired immunodeficiency syndrome (AIDS). HIV seropositive individuals are initially asymptomatic but typically develop AIDS related complex (ARC) followed by AIDS. Affected individuals exhibit severe immunosuppression which makes them highly susceptible to debilitating and ultimately fatal opportunistic infections. Replication of HIV by a host cell requires integration of the viral genome into the host cell's DNA. Since HIV is a retrovirus, the HIV replication cycle requires transcription of the viral RNA genome into DNA via an enzyme known as reverse transcriptase (RT).

Reverse transcriptase has three known enzymatic functions: The enzyme acts as an RNA-dependent DNA polymerase, as a ribonuclease, and as a DNA-dependent DNA polymerase. In its role as an RNA-dependent DNA polymerase, RT transcribes a single-stranded DNA copy of the viral RNA. As a ribonuclease, RT destroys the original viral RNA and frees the DNA just produced from the original RNA. During the viral RNA-dependent polymerization process, RT's ribonuclease activity is required for removing RNA and leaving the polypurine tract preserved for initiation of DNA-dependent polymerization. As a DNA-dependent DNA polymerase, RT makes a second, complementary DNA strand using the first DNA strand as a template. The two strands form double-stranded DNA, which is integrated into the host cell's genome by HIV integrase.

It is known that compounds that inhibit enzymatic functions of HIV RT will inhibit HIV replication in infected cells. These compounds are useful in the treatment of HIV infection in humans. Classes of RT inhibitors include non-nucleoside active site competitive RT inhibitors (NNRTIs), such as efavirenz (EFV), nevirapine (NVP), etravirine (ETR), and rilpivirine (RPV), and active site RT inhibitors which include nucleoside reverse transcriptase inhibitors (NsRTIs) and nucleotide reverse transcriptase inhibitors (NtRTIs), collectively referred to as NRTIs. Examples of NsRTI's include 3′-azido-3′-deoxythymidine (AZT), 2′,3′-dideoxyinosine (ddI), 2′,3′-dideoxycytidine (ddC), 2′,3′-didehydro-2′,3′-dideoxythymidine (d4T), 2′,3′-dideoxy-3′-thiacytidine (3TC), abacavir, emtricitabine and 4′-ethynyl-2-fluoro-2′-deoxyadenosine (EFdA) which is also known as a as nucleoside reverse transcriptase translocation inhibitor. Examples of NtRTIs include tenofovir (TFV, also known as PMPA, 9-(2-phosphonyl-methoxypropyl)adenine), tenofovir disoproxil fumarate (VIREAD®, U.S. Pat. Nos. 5,977,089, 5,935,946) and tenofovir alafenamide fumarate (U.S. Pat. Nos. 7,390,791, 8,754,065).

TFV belongs to a class of HIV anti-retroviral (ARV) agents known as nucleotide analog reverse transcriptase inhibitors (NRTIs). Tenofovir is a mono-phosphonate:

After being taken up by cells, TFV is first converted to tenofovir-monophosphate (TFV-MP) by adenosine monophosphate kinase and then to the active antiviral tenofovir-diphosphate (TFV-DP) by 5′-nucleoside diphosphate kinase.

TFV-DP inhibits HIV DNA synthesis by competing with the natural substrate, deoxyadenosine triphosphate, for incorporation into the complementary DNA strand by HIV reverse transcriptase; following incorporation, TFV acts as a chain terminator due to lack of a 3′-hydroxyl group that is required for addition of the next nucleotide. TFV has poor cellular permeability and thus has limited bioavailability. Tenofovir disoproxil fumarate (TDF) is approved for treating HIV infection and is marketed by Gilead under the trade name VIREAD™. The disoproxil prodrug improves cell permeability and absorption after oral dosing, with the pro-moiety being cleaved rapidly after absorption to yield the parent TFV. As a result, the circulating level of TFV is much higher than that of TDF. Tenofovir alafenamide fumarate (TAF) is currently approved by the USFDA as an active ingredient in combination with additional ARVs for treating HIV infection in the pharmaceutical products GENVOYA®, ODEFSEY® and DESCOVY®.

While each of the foregoing drugs is effective in treating HIV infection and AIDS, there remains a need to develop additional HIV antiviral drugs including additional RT inhibitors. A particular problem is the development of mutant HIV strains that are resistant to the known inhibitors. The use of RT inhibitors to treat AIDS often leads to viruses that are less sensitive to the inhibitors. This resistance is typically the result of mutations that occur in the reverse transcriptase segment of the pol gene. The continued use of antiviral compounds to prevent HIV infection will inevitably result in the emergence of new resistant strains of HIV. Accordingly, there is a particular need for new RT inhibitors that are effective against mutant HIV strains.

SUMMARY OF THE INVENTION

The present disclosure is directed to phosphinic amide prodrugs of tenofovir and their use in the inhibition of HIV reverse transcriptase. In addition to the use of said compounds in the inhibition of HIV reverse transcriptase, the disclosure is also directed to the use of said compounds for prophylaxis of infection by HIV, the treatment of infection by HIV, and the prophylaxis, treatment, and/or delay in the onset or progression of AIDS and/or ARC.

DETAILED DESCRIPTION OF THE INVENTION

The present disclosure is directed to compounds of structural Formula I:

-   -   or a pharmaceutically acceptable salt thereof, wherein:     -   R¹ is (a) —C₁₋₄alkyl, (b) —C₁₋₄alkyl substituted with —OH, —SH,         —SCH₃, —NH₂, —NH—C(═NH)—NH₂, (c) —CH₂-phenyl, (d)         —CH₂-phenol, (e) —(CH₂)₁₋₂—COOH, (f) —(CH₂)₁₋₂—CONH₂, (g)         —CH₂-1H-indole, (h) —CH₂-imidazole, (i) aryl or (j) heteroaryl;     -   R² is (a) —C₁₋₄alkyl, (b) —C₁₋₄alkyl substituted with —OH, —SH,         —SCH₃, —NH₂, —NH—C(═NH)—NH₂, (c) —CH₂-phenyl, (d)         —CH₂-phenol, (e) —(CH₂)₁₋₂—COOH, (f) —(CH₂)₁₋₂—CONH₂, (g)         —CH₂-1H-indole, (h) —CH₂-imidazole, (i) aryl or (j) heteroaryl;     -   or R¹ and R² are joined together with the carbon to which they         are both attached to form —C₃₋₆cycloalkyl or a 4 to 6-membered         heterocyclic ring;     -   R³ is —CN, —CF₃, phenyl, heteroaryl, —C(O)OR^(5b),         —C(O)—N(R^(6a))(R^(6b)), —S(O)₂R^(5b) or         —S(O)₂—N(R^(6a))(R^(6b)) wherein each of phenyl and heteroaryl         is unsubstituted or substituted with one to three substituents         independently selected at each occurrence from R¹⁰;     -   R⁴ is —H, —CN, —CF₃, phenyl, heteroaryl, —C(O)OR^(5c) or         —C(O)—N(R^(6c))(R^(6d)), —S(O)₂R^(5c) or         —S(O)₂—N(R^(6c))(R^(6d)) wherein each of phenyl and heteroaryl         is unsubstituted or substituted with one to three substituents         independently selected at each occurrence from R¹⁰;     -   R^(5a), R^(5b) and R^(5c) are each independently:         -   (a) —C₁₋₁₀alkyl unsubstituted or substituted with one to             three substituents, wherein each substituent is             independently fluoro, chloro, bromo, —CN, —CF₃,             —NR^(7a)R^(7b), —OR⁸, —SH, —C₃₋₆cycloalkyl or             spiro-C₃₋₆cycloalkyl,         -   (b) —CH₂-phenyl unsubstituted or substituted with one to             three substituents, wherein each substituent is             independently selected at each occurrence from R¹⁰,         -   (c) —C₃₋₈ cycloalkyl unsubstituted or substituted with one             to three substituents, wherein each substituent is             independently selected at each occurrence from R¹⁰,         -   (d) aryl unsubstituted or substituted with one to three             substituents, wherein each substituent is independently             selected at each occurrence from R¹⁰,         -   (e) —C₁₋₅ alkyl-X—C₁₋₅ alkyl wherein X is O, S or NH,         -   (f) heteroaryl unsubstituted or substituted with one to             three substituents, wherein each substituent is             independently selected at each occurrence from R¹⁰, or         -   (g) a heterocyclic ring unsubstituted or substituted with             one to three substituents, wherein each substituent is             independently selected at each occurrence from R¹⁰;     -   R^(6a), R^(6b), R^(6c) and R^(6d) are each independently —H,         —C₁₋₃alkyl or —C₃₋₆cycloalkyl;     -   R^(7a) and R^(7b) are each independently —H, —C₁₋₃alkyl or         —C₃₋₆cycloalkyl;     -   R⁸ is —H or —C₃₋₆cycloalkyl; and     -   R⁹ is —H, —C₁₋₃alkyl or —C₃₋₆cycloalkyl; and     -   R¹⁰ is fluoro, chloro, bromo, —CN, —CF₃, —NR^(7a)R^(7b), —OR⁹,         —SH or —C₁₋₃alkyl.

In Embodiment 1 of this disclosure are compounds of Formula I or a pharmaceutically acceptable salt thereof, wherein R¹ and R² are each —C₁₋₃alkyl. In a class thereof, R¹ and R² are both the same moiety wherein the moiety is methyl, ethyl, propyl or i-propyl. In a further class thereof, R¹ and R² are both methyl.

In Embodiment 2 of this disclosure are compounds of Formula I or Embodiment 1 or a class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein aryl, at each place where it is named in the definition of Formula I, is independently selected from unsubstituted or substituted phenyl.

In Embodiment 3 of this disclosure are compounds of Formula I, Embodiment 1 or Embodiment 2, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein heteroaryl, at each place where it is named in the definition of Formula I, is independently selected from unsubstituted or substituted pyridinyl.

In Embodiment 4 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2 or 3, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R³ is

-   -   (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH,         —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or         —CH₂CH₂CF₃;     -   (b) —CH₂-phenyl, unsubstituted or substituted with one to three         substituents, wherein each substituent is independently fluoro,         chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl,     -   (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl,     -   (d) phenyl or naphthyl, each unsubstituted or substituted with         one to three substituents, wherein each substituent is         independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or         —C₁₋₃alkyl,     -   (e) —CH₂CH₂OCH₃, —CH₂CH₂CH₂OCH₃, —CH₂CH₂SCH₃, —CH₂CH₂CH₂SCH₃,         —CH₂CH₂NHCH₃, —CH₂CH₂CH₂NHCH₃,     -   (f) pyridyl, unsubstituted or substituted with one to three         substituents, wherein each substituent is independently fluoro,         chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, or     -   (g) piperidinyl, pyrrolidinyl, tetrahydrofuranyl, or         tetrahydropyranyl, each unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl.

In Embodiment 4a of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3 or 4, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R⁴ is

-   -   (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH,         —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or         —CH₂CH₂CF₃;     -   (b) —CH₂-phenyl, unsubstituted or substituted with one to three         substituents, wherein each substituent is independently fluoro,         chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl,     -   (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl,     -   (d) phenyl or naphthyl, each unsubstituted or substituted with         one to three substituents, wherein each substituent is         independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or         —C₁₋₃alkyl,     -   (e) —CH₂CH₂OCH₃, —CH₂CH₂CH₂OCH₃, —CH₂CH₂SCH₃, —CH₂CH₂CH₂SCH₃,         —CH₂CH₂NHCH₃, —CH₂CH₂CH₂NHCH₃,     -   (f) pyridyl, unsubstituted or substituted with one to three         substituents independently, wherein each substituent is         independently from fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰         or —C₁₋₃alkyl, or     -   (g) piperidinyl, pyrrolidinyl, tetrahydrofuranyl, or         tetrahydropyranyl, each unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl.

In Embodiment 5 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4 or 4a, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R³ is:

-   -   (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH,         —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or         —CH₂CH₂CF₃;     -   (b) —CH₂-phenyl, unsubstituted or substituted with one to three         substituents, wherein each substituent is independently fluoro,         chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, or     -   (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl.         -   and R⁴ is:     -   (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH,         —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or         —CH₂CH₂CF₃;     -   (b) —CH₂-phenyl, unsubstituted or substituted with one to three         substituents, wherein each substituent is independently fluoro,         chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, or     -   (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to         three substituents, wherein each substituent is independently         fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl.

In Embodiment 6 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a or 5, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R³ is —C(O)OR^(5b) or —C(O)—N(R^(6a))(R^(6b)). In Embodiment 6a of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a or 5, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R³ is —CN or unsubstituted or substituted phenyl. In Embodiment 6b of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a or 5, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R³ is —C(O)OR^(5b), —C(O)—N(R^(6a))(R^(6b)), —CN or unsubstituted or substituted phenyl.

In Embodiment 6c of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a, 5, 6, 6a or 6b, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R⁴ is —H, —CN, unsubstituted or substituted phenyl or —C(O)OR^(5c), or —C(O)—N(R^(6c))(R^(6d)).

In Embodiment 7 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a, 5, 6, 6a, 6b or 6c, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R^(5a), R^(5b) and R^(5c) are each independently —C₁₋₁₀alkyl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected from fluoro, chloro, bromo, —CN, —CF₃, —NR^(7a)R^(7b), —OR^(8a), —SH, —C₃₋₆cycloalkyl or spiro-C₃₋₆cycloalkyl.

In Embodiment 8 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a, 5, 6, 6a, 6b or 6c, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R^(5a), R^(5b) and R^(5c) are each independently —C₁₋₁₀alkyl. In a class thereof, R^(5a), R^(5b) and R^(5c) are each independently —C₁₋₆alkyl, —C₁₋₅alkyl, —C₁₋₄alkyl or —C₁₋₃alkyl.

In Embodiment 9 of this disclosure are compounds of Formula I, or any one of Embodiments 1, 2, 3, 4, 4a, 5, 6, 6a, 6b, 6c, 7 or 8, or any class thereof, or a pharmaceutically acceptable salt of any of the foregoing, wherein R^(6a), R^(6b), R^(6c) and R^(6d) are each independently —C₁₋₆alkyl, —C₁₋₅alkyl, —C₁₋₄alkyl or —C₁₋₃alkyl.

In Embodiment 10 of this disclosure are compounds of Formula I or a pharmaceutically acceptable salt thereof wherein:

-   -   R¹ and R² are both methyl,     -   R³ is —CN, phenyl, —C(O)OR^(5b) or —C(O)—N(R^(6a))(R^(6b));     -   R⁴ is —H, —CN, phenyl, —C(O)OR^(5c) or —C(O)—N(R^(6c))(R^(6d));     -   each of R^(5a), R^(5b) and R^(5c) is —C₁₋₆alkyl; and     -   each of R^(6a), R^(6b), R^(6c) and R^(6d) is —C₁₋₆alkyl.

In Embodiment 11 of this disclosure are compounds of Formula I or a pharmaceutically acceptable salt thereof wherein:

-   -   R¹ and R² are both methyl,     -   R³ is —CN, phenyl, —C(O)OR^(5b) or —C(O)—N(R^(6a))(R^(6b));     -   R⁴ is —H, —CN, phenyl, —C(O)OR^(5c) or —C(O)—N(R^(6c))(R^(6d));         and     -   R^(5a) is —C₁₋₁₀alkyl.         In a class of Embodiment 11, each of R^(5a), R^(5b), R^(5c),         R^(6a), R^(6b), R^(6c) and R^(6d) is independently selected from         —C₁₋₆alkyl.

When a moiety in a compound of Formula I can be substituted with more than one substituent, the definition of each substituent is independently selected at each occurrence.

As used herein, “alkyl” refers to both branched- and straight-chain saturated aliphatic hydrocarbon groups having the specified number of carbon atoms in a specified range. For example the term “C₁₋₁₀alkyl” includes all of “C₁₋₈alkyl” defined as follows, plus the linear or branched chain alkyl groups, including all possible isomers, having 9 or 10 carbon atoms. “C₁₋₈alkyl” means linear or branched chain alkyl groups, including all possible isomers, having 1, 2, 3, 4, 5, 7 or 8 carbon atoms, and includes each of the octyl, heptyl, hexyl and pentyl isomers as well as n-, iso-, sec- and tert-butyl (butyl, i-butyl, s-butyl, t-butyl, collectively “C₄alkyl”; Bu=butyl), n- and i-propyl (propyl, i-propyl, collectively “C₃alkyl”; Pr=propyl), ethyl (Et) and methyl (Me). “C₁₋₆alkyl” has 1, 2, 3, 4, 5 or 6 carbon atoms and includes each of the alkyl groups within C₁₋₈alkyl except for those containing 7 or 8 carbon atoms. “C₁₋₄alkyl” has 1, 2, 3 or 4 carbon atoms and includes each of n-, i-, s- and t-butyl, n- and i-propyl, ethyl and methyl. “C₁₋₃alkyl” has 1, 2 or 3 carbon atoms and includes each of n-propyl, i-propyl, ethyl and methyl.

“Cycloalkyl” refers to a cyclized alkyl ring having the indicated number of carbon atoms in a specified range. Thus, for example, “C₃₋₈ cycloalkyl” includes each of cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl and cyclooctyl. In an embodiment of this disclosure, R^(5a), R^(5b) and R^(5c) can each independently be C₃₋₆ cycloalkyl. “C₃₋₆cycloalkyl” includes each of cyclopropyl, cyclobutyl, cyclopentyl and cyclohexyl. When cycloalkyl is a substituent on an alkyl group in a compound of Formula I, the cycloalkyl substituent can be bonded to any available carbon in the alkyl group. The following are illustrations of —C₃₋₆cycloalkyl substituents on an alkyl group wherein the substituent is cyclopropyl in bold:

“Spiro-C₃₋₆cycloalkyl” refers to a cycloalkyl ring bonded to a non-terminal carbon atom wherein the non-terminal carbon atom is shared with the cycloalkyl group. Spiro-C₃₋₆cycloalkyl includes each of spiro-cyclopropyl, spiro-cyclobutyl, spiro-cyclopentyl and spiro-cyclohexyl. The following is an illustration of a spiro-C₃₋₆cycloalkyl substituent wherein the substituent is spiro-cyclopropyl in bold:

Examples of —C₁₋₅alkyl-X—C₁₋₅alkyl groups include, but are not limited to, —CH₂CH₂OCH₃, —CH₂CH₂OCH₂CH₃, —CH₂CH₂CH₂OCH₃, —CH₂CH₂CH₂OCH₂CH₃, —CH₂CH₂SCH₃, —CH₂CH₂SCH₂CH₃, —CH₂CH₂CH₂SCH₃, —CH₂CH₂CH₂SCH₂CH₃, —CH₂CH₂NHCH₃, —CH₂CH₂NHCH₂CH₃, —CH₂CH₂CH₂NHCH₃, or —CH₂CH₂CH₂NHCH₂CH₃.

“Aryl” refers to (i) phenyl, (ii) 9- or 10-membered bicyclic, fused carbocylic ring systems in which at least one ring is aromatic, and (iii) 11- to 14-membered tricyclic, fused carbocyclic ring systems in which at least one ring is aromatic. Suitable aryls include, for example, substituted and unsubstituted phenyl and substituted and unsubstituted naphthyl. An aryl of particular interest is unsubstituted or substituted phenyl. Substituents on aryl include one to three substituents independently selected at each occurrence from R¹⁰.

“Halo” or “halogen” refers to chloro, fluoro, bromo or iodo; chloro, fluoro and bromo are a class of halogens of interest, and particularly chloro and fluoro.

“Heteroaryl” refers to (i) a 5- or 6-membered heteroaromatic ring containing from 1 to 4 heteroatoms independently selected from N, O and S, wherein each N is optionally in the form of an oxide, and (ii) a 9- or 10-membered bicyclic fused ring system, wherein the fused ring system of (ii) contains from 1 to 6 heteroatoms independently selected from N, O and S, wherein each ring in the fused ring system contains zero, one or more than one heteroatom, at least one ring is aromatic, each N is optionally in the form of an oxide, and each S in a ring which is not aromatic is optionally S(O) or S(O)₂. Examples of 5-membered heteroaromatic rings include, but are not limited to, pyrrolyl, pyrazolyl, triazolyl (i.e., 1,2,3-triazolyl or 1,2,4-triazolyl), triazolinone (e.g., 2,4-dihydro-3H-1,2,4-triazol-3-one), imidazolyl, tetrazolyl, furanyl, furanonyl (e.g., furan-2(5H)-one), thienyl, thiazolyl, isothiazolyl, oxazolyl, isooxazolyl, oxadiazolyl (i.e., the 1,2,3-, 1,2,4-, 1,2,5-(furazanyl), or 1,3,4-oxadiazolyl isomer), oxatriazolyl, and thiadiazolyl. Examples of 6-membered heteroaromatic rings include, but are not limited to, pyridyl (also referred to as pyridinyl), pyrimidinyl, pyrazinyl, pyridazinyl, and triazinyl. Examples of 9- and 10-membered heteroaromatic bicyclic fused ring systems include, but are not limited to, benzofuranyl, indolyl, indazolyl, naphthyridinyl, isobenzofuranyl, benzopiperidinyl, benzisoxazolyl, benzoxazolyl, chromenyl, quinolinyl, isoquinolinyl, isoindolyl, benzopiperidinyl, benzofuranyl, imidazo[1,2-a]pyridinyl, benzotriazolyl, indazolyl, indolinyl, and isoindolinyl. Substituents on heteroaryl include one to three substituents independently selected at each occurrence from R¹⁰.

The term “heterocyclic ring” refers to (i) a saturated 4- to 7-membered cyclized ring and (ii) an unsaturated, non-aromatic 4 to 7-membered cyclized ring comprised of carbon atoms and 1-4 heteratoms independently selected from O, N and S. Heterocyclic rings within the scope of this disclosure include, for example but are not limited to, azetidinyl, piperidinyl, morpholinyl, thiomorpholinyl, thiazolidinyl, isothiazolidinyl, oxazolidinyl, isoxazolidinyl, pyrrolidinyl, imidazolidinyl, piperazinyl, tetrahydrofuranyl, tetrahydrothienyl, pyrazolidinyl, hexahydropyrimidinyl, thiazinanyl, thiazepanyl, azepanyl, diazepanyl, tetrahydropyranyl, tetrahydrothiopyranyl, and dioxanyl. Examples of 4- to 7-membered, unsaturated, non-aromatic heterocyclic rings within the scope of this disclosure include mono-unsaturated heterocyclic rings corresponding to the saturated heterocyclic rings listed in the preceding sentence in which a single bond is replaced with a double bond (e.g., a carbon-carbon single bond is replaced with a carbon-carbon double bond). Substituents on a heterocyclic ring include one to three substituents independently selected at each occurrence from R¹⁰.

In a class of heterocyclic rings are unsubstituted or substituted 4 to 6-membered saturated monocyclic rings comprised of carbon atoms and 1 or 2 heteroatoms, wherein the heteroatoms are selected from N, O and S. Examples of 4 to 6 membered heterocyclic rings include but are not limited to, azetidinyl, pyrrolidinyl, piperidinyl, piperazinyl, morpholinyl, thiomorpholinyl, tetrahydrofuranyl, tetrahydropyranyl and tetrahydrothiopyranyl, and a sub-class thereof is piperidinyl, pyrrolidinyl, tetrahydrofuranyl and tetrahydropyranyl.

The following is an illustration of R¹ and R² when they are joined together to form a heterocyclic ring:

It is understood that the specific rings and ring systems suitable for use in the present disclosure are not limited to those listed in the preceding paragraphs. These rings and ring systems are merely representative.

As would be recognized by one of ordinary skill in the art, certain compounds of the present disclosure may be able to exist as tautomers. All tautomeric forms of these compounds, whether isolated individually or in mixtures, are within the scope of the present disclosure. For example, in instances where an —OH substituent is permitted on a heteroaromatic ring and keto-enol tautomerism is possible, it is understood that the substituent might in fact be present, in whole or in part, in the oxo (═O) form.

A “stable” compound is a compound which can be prepared and isolated and whose structure and properties remain or can be caused to remain essentially unchanged for a period of time sufficient to allow use of the compound for the purposes described herein (e.g., therapeutic or prophylactic administration to a subject). The compounds of the present disclosure are limited to stable compounds embraced by Formula I and its embodiments. For example, certain moieties as defined in Formula I may be unsubstituted or substituted, and the latter is intended to encompass substitution patterns (i.e., number and kind of substituents) that are chemically possible for the moiety and that result in a stable compound.

Each compound of Formula I is comprised of a phosphinic amide having a defined (R) chiral center in the alkyl-ether linking group which connects the nucleobase to the phosphorus as shown in Formula I, and may have one or more additional chiral centers depending on substituent selection. For example, each of the compounds in Examples 1-9 herein has an asymmetric phosphorus center. Accordingly, a compound of Formula I may have multiple chiral centers (also referred to as asymmetric or stereogenic centers). This disclosure encompasses compounds of Formula I having either the (R) or (S) stereo-configuration at a phosphorus asymmetric center and at any additional asymmetric centers that may be present in a compound of Formula I, as well as stereo-isomeric mixtures thereof.

This disclosure includes individual diastereomers, particularly epimers, i.e., compounds having the same chemical formula but which differ in the spatial arrangement around a single atom. This disclosure also includes mixtures of diastereomers, particularly mixtures of epimers, in all ratios. Embodiments of this disclosure also include a mixture of epimers enriched with 51% or more of one of the epimers, including for example 60% or more, 70% or more, 80% or more, or 90% or more of one epimer. A single epimer is preferred. An individual or single epimer refers to an epimer obtained by chiral synthesis and/or using generally known separation and purification techniques, and which may be 100% of one epimer or may contain small amounts (e.g., 10% or less) of the opposite epimer. Thus, individual diastereomers are a subject of this disclosure in pure form, both as levorotatory and as dextrorotatory antipodes, in the form of racemates and in the form of mixtures of the two diastereomers in all ratios. In the case of a cis/trans isomerism this disclosure includes both the cis form and the trans form as well as mixtures of these forms in all ratios.

The preparation of individual stereoisomers can be carried out, if desired, by separation of a mixture by customary methods, for example by chromatography or crystallization, by the use of stereochemically uniform starting materials for the synthesis or by stereoselective synthesis. Optionally a derivatization can be carried out before a separation of stereoisomers. The separation of a mixture of stereoisomers can be carried out at an intermediate step during the synthesis of a compound of Formula I or it can be done on a final racemic product. Absolute stereochemistry may be determined by X-ray crystallography of crystalline products or crystalline intermediates which are derivatized, if necessary, with a reagent containing a stereogenic center of known configuration. Alternatively, absolute stereochemistry may be determined by Vibrational Circular Dichroism (VCD) spectroscopy analysis. The present disclosure includes all such isomers, as well as salts, solvates (which includes hydrates) and solvated salts of such racemates, enantiomers, diastereomers and tautomers and mixtures thereof.

The atoms in a compound of Formula I may exhibit their natural isotopic abundances, or one or more of the atoms may be artificially enriched in a particular isotope having the same atomic number, but an atomic mass or mass number different from the atomic mass or mass number predominantly found in nature. The present disclosure is meant to include all suitable isotopic variations of the compounds of Formula I; for example, different isotopic forms of hydrogen (H) include protium (¹H) and deuterium (²H). Protium is the predominant hydrogen isotope found in nature. Enriching for deuterium may afford certain therapeutic advantages, such as increasing in vivo half-life or reducing dosage requirements, or may provide a compound useful as a standard for characterization of biological samples. Isotopically-enriched compounds of Formula I can be prepared without undue experimentation by conventional techniques well known to those skilled in the art or by processes analogous to those described in the Schemes and Examples herein using appropriate isotopically-enriched reagents and/or intermediates.

The compounds can be administered in the form of pharmaceutically acceptable salts. The term “pharmaceutically acceptable salt” refers to a salt which is not biologically or otherwise undesirable (e.g., is neither toxic nor otherwise deleterious to the recipient thereof). Since the compounds of Formula I contain by definition at least one basic group, this disclosure includes the corresponding pharmaceutically acceptable salts. When the compounds of Formula I contain one or more acidic groups, the disclosure also includes the corresponding pharmaceutically acceptable salts. Thus, the compounds of Formula I that contain acidic groups (e.g., —COOH) could be used according to the disclosure as, for example but not limited to, alkali metal salts, alkaline earth metal salts or as ammonium salts. Examples of such salts include but are not limited to sodium salts, potassium salts, calcium salts, magnesium salts or salts with ammonia or organic amines such as, for example, ethylamine, ethanolamine, triethanolamine or amino acids. Compounds of Formula I, which contain one or more basic groups, i.e. groups which can be protonated, could be used according to the disclosure in the form of their acid addition salts with inorganic or organic acids as, for example but not limited to, salts with hydrogen chloride, hydrogen bromide, phosphoric acid, sulfuric acid, nitric acid, benzenesulfonic acid, methanesulfonic acid, p-toluenesulfonic acid, naphthalenedisulfonic acids, oxalic acid, acetic acid, trifluoroacetic acid, tartaric acid, lactic acid, salicylic acid, benzoic acid, formic acid, propionic acid, pivalic acid, diethylacetic acid, malonic acid, succinic acid, pimelic acid, fumaric acid, maleic acid, malic acid, sulfaminic acid, phenylpropionic acid, gluconic acid, ascorbic acid, isonicotinic acid, citric acid, adipic acid, etc. If the compounds of Formula I simultaneously contain acidic and basic groups in the molecule, the disclosure also includes, in addition to the salt forms mentioned, inner salts or betaines (zwitterions). Salts can be obtained from the compounds of Formula I by customary methods which are known to the person skilled in the art, for example by combination with an organic or inorganic acid or base in a solvent or dispersant, or by anion exchange or cation exchange from other salts. The present disclosure also includes all salts of the compounds of Formula I which, owing to low physiological compatibility, are not directly suitable for use in pharmaceuticals but which could be used, for example, as intermediates for chemical reactions or for the preparation of pharmaceutically acceptable salts.

The instant disclosure encompasses any composition comprised of a compound of Formula I or a compound that is a salt thereof, including for example but not limited to, a composition comprised of said compound associated together with one or more additional molecular and/or ionic component(s) which may be referred to as a “co-crystal.” The term “co-crystal” as used herein refers to a solid phase (which may or may not be crystalline) wherein two or more different molecular and/or ionic components (generally in a stoichiometric ratio) are held together by non-ionic interactions including but not limited to hydrogen-bonding, dipole-dipole interactions, dipole-quadrupole interactions or dispersion forces (van der Waals). There is no proton transfer between the dissimilar components and the solid phase is neither a simple salt nor a solvate. A discussion of co-crystals can be found, e.g., in S. Aitipamula et al., Crystal Growth and Design, 2012, 12 (5), pp. 2147-2152.

More specifically with reference to this disclosure, a co-crystal is comprised of a compound of Formula I or a pharmaceutically acceptable salt thereof, and one or more non-pharmaceutically active component(s) which is not biologically or otherwise undesirable (e.g., is neither toxic nor otherwise deleterious to the recipient thereof). Co-crystals can be obtained from a compound of Formula I, or a pharmaceutically acceptable salt thereof, by customary methods known in the chemical arts. For example, co-crystals comprised of a compound of this disclosure could be prepared by adding an acid or a neutral molecule at the desired stoichiometry to the compound, adding an appropriate solvent to achieve dissolution and, for example, precipitating, lyophilizing or concentrating the solution to obtain the solid composition. The co-crystal can be, but is not limited to, an embodiment wherein the composition is comprised of a neutral compound (i.e. not a salt form) of Formula I and one or more non-pharmaceutically active component(s); and in a further embodiment, the co-crystal composition is crystalline. Crystalline compositions may be prepared, for example, by adding an acid or a neutral molecule at the desired stoichiometry to the compound of Formula I, adding an appropriate solvent and heating to achieve complete dissolution, and then allowing the solution to cool and crystals to grow. The present disclosure also includes all co-crystals of the compounds of this disclosure which, owing to low physiological compatibility, are not directly suitable for use in pharmaceuticals but which can be used, for example, as intermediates for chemical reactions or for the preparation of pharmaceutically acceptable co-crystals or salts.

Furthermore, compounds of the present disclosure may exist in amorphous form and/or one or more crystalline forms, and as such all amorphous and crystalline forms and mixtures thereof of the compounds of Formula I and salts thereof are intended to be included within the scope of the present disclosure. In addition, some of the compounds of the instant disclosure may form solvates with water (i.e., a hydrate) or common organic solvents. Such solvates and hydrates, particularly the pharmaceutically acceptable solvates and hydrates, of the compounds of this disclosure are likewise encompassed within the scope of the compounds defined by Formula I and the pharmaceutically acceptable salts thereof, along with un-solvated and anhydrous forms of such compounds.

Accordingly, the compounds of Formula I or salts thereof including pharmaceutically acceptable salts thereof, embodiments thereof and specific compounds described and claimed herein, encompass, stereoisomers, tautomers, physical forms (e.g., amorphous and crystalline forms), co-crystal forms, solvate and hydrate forms, and any combination of the foregoing forms where such forms are possible.

Another embodiment of the present disclosure is a compound of Formula I wherein the compound or its salt is in a substantially pure form. As used herein “substantially pure” means suitably at least about 60 wt. %, typically at least about 70 wt. %, preferably at least about 80 wt. %, more preferably at least about 90 wt. % (e.g., from about 90 wt. % to about 99 wt. %), even more preferably at least about 95 wt. % (e.g., from about 95 wt. % to about 99 wt. %, or from about 98 wt. % to 100 wt. %), and most preferably at least about 99 wt. % (e.g., 100 wt. %) of a product containing a compound of Formula I or its salt (e.g., the product isolated from a reaction mixture affording the compound or salt) consists of the compound or salt. The level of purity of the compounds and salts can be determined using a standard method of analysis such as, high performance liquid chromatography, and/or mass spectrometry or NMR techniques. If more than one method of analysis is employed and the methods provide experimentally significant differences in the level of purity determined, then the method providing the highest purity level governs. A compound or salt of 100% purity is one which is free of detectable impurities as determined by a standard method of analysis. With respect to a compound of the disclosure which has one or more asymmetric centers and can occur as mixtures of stereoisomers, a substantially pure compound can be either a substantially pure mixture of the stereoisomers or a substantially pure individual stereoisomer.

The compounds of Formula I described herein are prodrugs. A discussion of prodrugs is provided in (a) Stella, V. J.; Borchardt, R. T.; Hageman, M. J.; Oliyai, R.; Maag, H. et al. Prodrugs: Challenges and Rewards Part 1 and Part 2; Springer, p. 726: New York, N.Y., USA, 2007, (b) Rautio, J.; Kumpulainen, H.; Heimbach, T.; Oliyai, R.; Oh, D. et al. Prodrugs: design and clinical applications. Nat. Rev. Drug Discov. 2008, 7, 255, (c) T. Higuchi and V. Stella, Pro-drugs as Novel Delivery Systems (1987) 14 of the A.C.S. Symposium Series, and in (d) Bioreversible Carriers in Drug Design, (1987) Edward B. Roche, ed., American Pharmaceutical Association and Pergamon Press. More specifically, compounds of Formula I pharmaceutically acceptable salts thereof (or any embodiment thereof) are prodrug modifications of tenofovir, which is a mono-phosphonate. The compounds described herein may be converted intracellularly (in vivo or in vitro) to the corresponding monophosphate or diphosphate of tenofovir. The conversion may occur by one or more mechanisms, e.g., an enzyme-catalyzed chemical reaction, a metabolic chemical reaction, and/or a spontaneous chemical reaction (e.g., solvolysis), such as, for example, through hydrolysis in blood. Tenofovir diphosphate is generally understood to be responsible for inhibiting the HIV RT enzyme and for the resulting antiviral activity after administration of the compound of Formula I, or a pharmaceutically acceptable salt thereof, to a subject.

The compounds of Formula I and pharmaceutically acceptable salts thereof can be useful for HIV reverse transcriptase inhibition and for inhibiting HIV replication in vitro and in vivo. More particularly, the compounds of Formula I can be useful for inhibiting the polymerase function of HIV-1 reverse transcriptase. The testing of compounds of the Examples of this disclosure in the human PBMC based HIV-1 replication Assay set forth in Example 10, below, illustrate the HIV antiviral potency of said compounds. The compounds of Formula I may also be useful agents against HIV-2. The compounds of Examples 1-9 of the present disclosure may also exhibit activity against drug resistant forms of HIV (e.g., NNRTI-associated mutant strains K103N and/or Y181C; NRTI-associated mutant strains M184V and M184I mutants).

This disclosure also encompasses methods for the treatment or prophylaxis of infection by HIV, for the inhibition of HIV reverse transcriptase, for the treatment, prophylaxis, or delay in the onset of AIDS in a subject in need thereof, which comprise administering to the subject an effective amount of a compound of the disclosure or a pharmaceutically acceptable salt thereof.

This disclosure further encompasses methods for the treatment or prophylaxis of infection by HIV, for the inhibition of HIV reverse transcriptase, for the treatment, prophylaxis, or delay in the onset of AIDS in a subject in need thereof, which comprise administering to the subject an effective amount of a compound of this disclosure or a pharmaceutically acceptable salt thereof in combination with an effective amount of one or more additional anti-HIV agents selected from HIV antiviral agents, immunomodulators, and anti-infective agents. Within this embodiment, the one or more anti-HIV agents can be antiviral agents selected from HIV protease inhibitors, HIV reverse transcriptase inhibitors (including both non-nucleoside and nucleoside reverse transcriptase inhibitors), HIV integrase inhibitors, HIV fusion inhibitors, HIV entry inhibitors, and HIV maturation inhibitors.

This disclosure encompasses a pharmaceutical composition comprising an effective amount of a compound of this disclosure, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier. The disclosure also encompasses a pharmaceutical composition comprising an effective amount of a compound of the disclosure, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier, further comprising an effective amount of one or more additional anti-HIV agents selected from HIV antiviral agents, immunomodulators, and anti-infective agents. Within this embodiment, the one or more anti-HIV agents can be antiviral agents selected from HIV protease inhibitors, HIV reverse transcriptase inhibitors (including both non-nucleoside and nucleoside reverse transcriptase inhibitors), HIV integrase inhibitors, HIV fusion inhibitors, HIV entry inhibitors, and HIV maturation inhibitors.

The compounds of this disclosure could also be useful for inhibition of HBV reverse transcriptase. Accordingly, this disclosure also encompasses methods for the treatment of chronic hepatitis B which comprise administering to the subject an effective amount of a compound of the disclosure or a pharmaceutically acceptable salt thereof.

This disclosure also encompasses a compound of the disclosure, or a pharmaceutically acceptable salt thereof, for use in the preparation of a medicament for the inhibition of HIV reverse transcriptase, for the treatment or prophylaxis of infection by HIV, or for the treatment, prophylaxis, or delay in the onset of AIDS in a subject in need thereof.

Other embodiments of the present disclosure include the following (wherein reference to Formula I encompasses the compounds of Formula I and each of the embodiments and classes thereof, and each of the final compounds of the Examples herein):

-   -   (a) A pharmaceutical composition comprising an effective amount         of a compound of Formula I or a pharmaceutically acceptable salt         thereof, and a pharmaceutically acceptable carrier.     -   (b) A pharmaceutical composition which comprises the product         prepared by combining (e.g., mixing) an effective amount of a         compound of Formula I or a pharmaceutically acceptable salt         thereof, and a pharmaceutically acceptable carrier.     -   (c) The pharmaceutical composition of (a) or (b), further         comprising an effective amount of one or more an anti-HIV agents         selected from HIV antiviral agents, immunomodulators, and         anti-infective agents.     -   (d) The pharmaceutical composition of (c), wherein the one or         more anti-HIV agent is selected from one or more of an antiviral         selected from HIV protease inhibitors, nucleoside HIV reverse         transcriptase inhibitors, non-nucleoside HIV reverse         transcriptase inhibitors, HIV integrase inhibitors, HIV fusion         inhibitors, HIV entry inhibitors and HIV maturation inhibitors.     -   (e) A combination which is (i) a compound of Formula I or a         pharmaceutically acceptable salt thereof and (ii) one or more         anti-HIV agents selected from HIV antiviral agents,         immunomodulators, and anti-infective agents; wherein the         compound and the anti-HIV agent are each employed in an amount         that renders the combination effective for inhibition of HIV         reverse transcriptase, for treatment or prophylaxis of infection         by HIV, or for treatment, prophylaxis of, or delay in the onset         or progression of AIDS.     -   (f) The combination of (e), wherein the one or more anti-HIV         agent is an antiviral selected from HIV protease inhibitors,         nucleoside HIV reverse transcriptase inhibitors, non-nucleoside         HIV reverse transcriptase inhibitors, HIV integrase inhibitors,         HIV fusion inhibitors, HIV entry inhibitors and HIV maturation         inhibitors.     -   (g) A method for the inhibition of HIV reverse transcriptase in         a subject in need thereof which comprises administering to the         subject an effective amount of a compound of Formula I or         pharmaceutically acceptable salt thereof.     -   (h) A method for the prophylaxis or treatment of infection by         HIV (e.g., HIV-1) in a subject in need thereof which comprises         administering to the subject an effective amount of a compound         of Formula I or pharmaceutically acceptable salt thereof.     -   (i) The method of (h), wherein the compound of Formula I or a         pharmaceutically acceptable salt thereof is administered in         combination with an effective amount of at least one other HIV         antiviral selected from HIV protease inhibitors, HIV integrase         inhibitors, non-nucleoside HIV reverse transcriptase inhibitors,         nucleoside HIV reverse transcriptase inhibitors, HIV fusion         inhibitors, HIV entry inhibitors and HIV maturation inhibitors.     -   (j) A method for the prophylaxis, treatment or delay in the         onset or progression of AIDS in a subject in need thereof which         comprises administering to the subject an effective amount of a         compound of Formula I or pharmaceutically acceptable salt         thereof.     -   (k) The method of (j), wherein the compound is administered in         combination with an effective amount of at least one other HIV         antiviral selected from HIV protease inhibitors, HIV integrase         inhibitors, non-nucleoside HIV reverse transcriptase inhibitors,         nucleoside HIV reverse transcriptase inhibitors, HIV fusion         inhibitors, HIV entry inhibitors and HIV maturation inhibitors.     -   (l) A method for the inhibition of HIV reverse transcriptase in         a subject in need thereof which comprises administering to the         subject the pharmaceutical composition of (a), (b), (c) or (d)         or the combination of (e) or (f).     -   (m) A method for the prophylaxis or treatment of infection by         HIV (e.g., HIV-1) in a subject in need thereof, which comprises         administering to the subject the pharmaceutical composition of         (a), (b), (c) or (d) or the combination of (e) or (f).     -   (n) A method for the prophylaxis, treatment, or delay in the         onset or progression of AIDS in a subject in need thereof which         comprises administering to the subject the pharmaceutical         composition of (a), (b), (c) or (d) or the combination of (e) or         (f).

The present disclosure also includes compounds of Formula I and each of the embodiments, classes and sub-classes thereof, and each of the compounds of the Examples herein, or pharmaceutically acceptable salts of the foregoing, (i) for use in, (ii) for use as a medicament for, or (iii) for use in the preparation of a medicament for: (a) therapy (e.g., of the human body), (b) medicine, (c) inhibition of HIV reverse transcriptase, (d) treatment or prophylaxis of infection by HIV, or (e) treatment, prophylaxis of, or delay in the onset or progression of AIDS. In these uses, the compounds of the present disclosure can optionally be employed in combination with one or more anti-HIV agents selected from HIV antiviral agents, anti-infective agents, and immunomodulators.

Additional embodiments of the present disclosure include each of the compounds of Formula I, and pharmaceutical compositions, combinations, and methods and uses set forth in the preceding paragraphs, wherein the compound or its salt employed therein is substantially pure. With respect to a pharmaceutical composition comprising a compound of Formula I or its salt and a pharmaceutically acceptable carrier and optionally one or more excipients, it is understood that the term “substantially pure” is in reference to a compound of Formula I or its salt per se.

Still additional embodiments of the present disclosure include the pharmaceutical compositions, combinations and methods set forth in (a)-(n) above and the uses (i)(a)-(e) through (iii)(a)-(e) set forth above, wherein the HIV of interest is HIV-1. Thus, for example, in the pharmaceutical composition (d), the compound of Formula I is employed in an amount effective against HIV-1 and the anti-HIV agent is an HIV-1 antiviral selected from HIV-1 protease inhibitors, HIV-1 reverse transcriptase inhibitors, HIV-1 integrase inhibitors, HIV-1 fusion inhibitors, HIV-1 entry inhibitors and HIV-1 maturation inhibitors.

In all of the embodiments etc., herein, the compound may optionally be used in the form of a pharmaceutically acceptable salt.

The term “administration” and variants thereof (e.g., “administering” a compound) in reference to a compound of Formula I means providing the compound to the individual in need of treatment or prophylaxis and includes both self-administration and administration to the patient by another person. When a compound is provided in combination with one or more other active agents (e.g., antiviral agents useful for treating or prophylaxis of HIV infection or AIDS), “administration” and its variants are each understood to include provision of the compound and other agents at the same time or at different times. When the agents of a combination are administered at the same time, they can be administered together in a single composition or they can be administered separately.

As used herein, the term “composition” is intended to encompass a product comprising the specified ingredients, as well as any product which results from combining the specified ingredients. Ingredients suitable for inclusion in a pharmaceutical composition are pharmaceutically acceptable ingredients, which means the ingredients must be compatible with each other and not deleterious to the recipient thereof.

The term “subject” or “patient” as used herein refers to an animal, preferably a mammal, most preferably a human, who is or has been the object of treatment, observation or experiment.

The term “effective amount” as used herein means an amount of a compound sufficient to inhibit HIV reverse transcriptase, inhibit HIV replication, exert a prophylactic effect, and/or a exert a therapeutic effect after administration. One embodiment of “effective amount” is a “therapeutically effective amount” which is an amount of a compound that is effective for inhibiting HIV reverse transcriptase, inhibiting HIV replication (either of the foregoing which may also be referred to herein as an “inhibition effective amount”), treating HIV infection, treating AIDS, delaying the onset of AIDS, and/or slowing progression of ARC or AIDS in a patient infected with HIV. Another embodiment of “effective amount” is a “prophylactically effective amount” which is an amount of the compound that is effective for prophylaxis of HIV infection in a subject not infected with HIV, or prophylaxis of ARC or AIDS in an HIV-infected patient. It is understood that an effective amount can simultaneously be both a therapeutically effective amount, e.g., for treatment of HIV infection, and a prophylactically effective amount, e.g., for prevention or reduction of risk for developing AIDS in a subject infected with HIV. The term “preventing,” as used herein with respect to an HIV viral infection or AIDS, refers to reducing the likelihood or severity of HIV infection or AIDS. In the combination therapies of the present disclosure, an effective amount can refer to each individual agent or to the combination as a whole, wherein the amounts of all agents administered in the combination are together effective, but wherein a component agent of the combination may or may not be present individually in an effective amount with reference to what is considered effective for that component agent if it were administered alone.

When the compound of Formula I is administered as a salt, reference to an amount of the compound in milligrams or grams is based on the free form (i.e., the non-salt form) of the compound. In the method of the present disclosure (i.e., inhibiting HIV reverse transcriptase, treating or prophylaxis of HIV infection, inhibiting HIV replication, treating or prophylaxis of AIDS, delaying the onset of AIDS, or delaying or slowing progression of AIDS), the compounds of this disclosure, optionally in the form of a salt, can be administered by means that produce contact of the active agent with the agent's site of action. They can be administered by conventional means available for use in conjunction with pharmaceuticals, either as individual therapeutic agents or in a combination of therapeutic agents. They can be administered alone, but typically are administered with a pharmaceutical carrier selected on the basis of the chosen route of administration and standard pharmaceutical practice. The compounds of the disclosure can, for example, be administered orally (e.g., via tablet or capsule), parenterally (including subcutaneous injections, intravenous, intramuscular or intrasternal injection, or infusion techniques), by inhalation spray, or rectally, in the form of a unit dosage of a pharmaceutical composition containing an effective amount of the compound and conventional non-toxic pharmaceutically acceptable carriers, adjuvants and vehicles. The compound could also be administered via an implantable drug delivery device adapted to provide an effective amount of the compound or a pharmaceutical composition of the compound over an extended period of time for example, but not limited to, over the course of a month, 3 months, 6 months or a year.

Solid preparations suitable for oral administration (e.g., powders, pills, capsules and tablets) can be prepared according to techniques known in the art and can employ such solid excipients as starches, sugars, kaolin, lubricants, binders, disintegrating agents and the like. Liquid preparations suitable for oral administration (e.g., suspensions, syrups, elixirs and the like) can be prepared according to techniques known in the art and can employ any of the usual media such as water, glycols, oils, alcohols and the like. Parenteral compositions can be prepared according to techniques known in the art and typically employ sterile water as a carrier and optionally other ingredients, such as a solubility aid. Injectable solutions can be prepared according to methods known in the art wherein the carrier comprises a saline solution, a glucose solution or a solution containing a mixture of saline and glucose. Implantable compositions can be prepared according to methods known in the art wherein the carrier comprises the active chemical ingredient with polymers as suitable excipients, or utilizing an implantable device for drug delivery. Further description of methods suitable for use in preparing pharmaceutical compositions for use in the present disclosure and of ingredients suitable for use in said compositions is provided in Remington—The Science and Practice of Pharmacy, 22nd Edition, published by Pharmaceutical Press and Philadelphia College of Pharmacy at University of the Sciences, 2012, ISBN 978 0 85711-062-6 and prior editions.

Formulations of compounds described by Formula I that result in drug supersaturation and/or rapid dissolution may be utilized to facilitate oral drug absorption. Formulation approaches to cause drug supersaturation and/or rapid dissolution include, but are not limited to, nanoparticulate systems, amorphous systems, solid solutions, solid dispersions, and lipid systems. Such formulation approaches and techniques for preparing them are well known in the art. For example, solid dispersions can be prepared using excipients and processes as described in reviews (e.g., A. T. M. Serajuddin, J Pharm Sci, 88:10, pp. 1058-1066 (1999)). Nanoparticulate systems based on both attrition and direct synthesis have also been described in reviews such as Wu et al (F. Kesisoglou, S. Panmai, Y. Wu, Advanced Drug Delivery Reviews, 59:7 pp. 631-644 (2007)).

The compounds of Formula I can be administered in a dosage range of 0.001 to 1000 mg/kg of mammal (e.g., human) body weight per day, or at longer time intervals on non consecutive days as appropriate, in a single dose or in divided doses. One example of a dosage range is 0.01 to 500 mg/kg body weight per day, or at other time intervals as appropriate, administered orally or via other routes of administration in a single dose or in divided doses. Another example of a dosage range is 0.1 to 100 mg/kg body weight per day, or at other time intervals as appropriate, administered orally or via other routes of administration in single or divided doses. Another example of a dosage range is 50 mg to 1 gram per day, in a single dose or divided doses.

Daily or weekly administration or less frequent dosing regimens with longer time intervals on non-consecutive days (as discussed below), can be via any suitable route of administration, e.g. but not limited to, oral or parenteral. Daily or weekly administration is preferably via oral administration. For either a daily or weekly dosing regimen, on each day (calendar day or about a 24 hour period of time) of drug administration (the “administration day”), the desired dosage amount may be administered once per administration day or in divided dosage amounts administered at two or more staggered times during the administration day, e.g., a first administration followed about 12 hours later with a second administration during the course of an administration day (the “dosage time(s)”). The desired dosage amount at each of the one or more dosage times on an administration day can be administered via one oral dosage unit such as a tablet, or more than one oral dosage unit as appropriate. Preferably the administration is via a single oral dosage unit, e.g. a tablet, once per administration day.

For weekly or less frequent dosing regimens with longer time intervals on non-consecutive days, a parenteral route of administration may be employed. Examples of dosing regimens with longer time intervals on non-consecutive days include but are not limited to administration weekly (every seventh day with leeway as to exact date of dosing), bi-weekly (every two weeks with leeway as to exact date of dosing), monthly (e.g., every 30 days, or the same calendar day each month with leeway as to exact date of dosing), bimonthly (e.g., every 60 days, or the same calendar day every two months with leeway as to exact date of dosing), every 3 months (e.g., every 90 days, or the same calendar day every three months with leeway as to exact date of dosing), every six months (e.g., every 180 days, or the same calendar day every six months with leeway as to exact date of dosing), or yearly (e.g., every 12 months with leeway as to exact date of the annual dosing). “Leeway” is intended to mean that the dosing regimens described herein also encompasses those wherein the patient generally follows the time intervals between administration days including when the interval is not always strictly followed by the patient, e.g., a weekly dosing regimen where the patient may take the drug product the day before or the day after the seventh day following the prior administration day for one or more weeks. The leeway time may increase as the dosing regimen interval increases.

For oral (e.g., tablets or capsules) or other routes of administration, the dosage units may contain 1.0 mg to 1000 mg of the active ingredient, for example but not limited to, 1, 5, 10, 15, 20, 25, 50, 75, 100, 150, 200, 250, 300, 350, 400, 450, 500, 600, 700, 800, 900 or 1000 milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated. Furthermore, the compound may be formulated in oral formulations for immediate or modified release such as extended or controlled release.

The favorable pharmacokinetic profile of tested compounds of this disclosure may also render the compounds suitable for less frequent dosing. Thus, the compounds of the disclosure could be administered orally, weekly or parenterally at longer time intervals as described above. For parenteral administration, the compositions can be administered, e.g., intravenously (IV) or intramuscularly (IM) via injection, or using other infusion techniques. One or more of such injections or infusions may be administered at each dosing time interval as needed to deliver the appropriate amount of active agent. The compound could also be administered subcutaneously using an implantable device. For parenteral administration including implantable devices employing longer duration dosing intervals such as monthly, every 3 months, every 6 months, yearly or longer intervals, the dosage amount would be adjusted upward as needed to provide effective treatment during the time intervals between administration of each dose.

The specific dose level and frequency of dosage for any particular patient may be varied and will depend upon a variety of factors including the activity of the specific compound employed, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the host undergoing therapy. In some cases, depending on the potency of the compound or the individual response, it may be necessary to deviate upwards or downwards from the given dose. The amount and frequency of administration will be regulated according to the judgment of the attending clinician considering such factors.

As noted above, the present disclosure is also directed to use of a compound of Formula I with one or more anti-HIV agents. An “anti-HIV agent” is any agent which is directly or indirectly effective in the inhibition of HIV, the treatment or prophylaxis of HIV infection, and/or the treatment, prophylaxis or delay in the onset or progression of AIDS. It is understood that an anti-HIV agent is effective in treating, preventing, or delaying the onset or progression of HIV infection or AIDS and/or diseases or conditions arising therefrom or associated therewith. For example, the compounds of this disclosure may be effectively administered, whether at periods of pre-exposure and/or post-exposure to HIV, in combination with effective amounts of one or more anti-HIV agents selected from HIV antiviral agents, imunomodulators, antiinfectives, or vaccines useful for treating HIV infection or AIDS. Suitable HIV antivirals for use in combination with the compounds of the present disclosure include, for example, those listed in Table 1 as follows:

TABLE 1 Antiviral Agents for Treating HIV infection or AIDS Name Type abacavir, abacavir sulfate, ABC, Ziagen ® nRTI abacavir + lamivudine, Epzicom ® nRTI abacavir + lamivudine + zidovudine, Trizivir ® nRTI amprenavir, Agenerase ® PI atazanavir, atazanavir sulfate, Reyataz ® PI AZT, zidovudine, azidothymidine, Retrovir ® nRTI capravirine nnRTI darunavir, Prezista ® PI ddC, zalcitabine, dideoxycytidine, Hivid ® nRTI ddI, didanosine, dideoxyinosine, Videx ® nRTI ddI (enteric coated), Videx EC ® nRTI delavirdine, delavirdine mesylate, DLV, Rescriptor ® nnRTI dolutegravir, Tivicay ® InI doravirine, MK-1439 nnRTI efavirenz, EFV, Sustiva ®, Stocrin ® nnRTI EFdA (4′-ethynyl-2-fluoro-2′-deoxyadenosine) nRTI elvitegravir InI emtricitabine, FTC, Emtriva ® nRTI emivirine, Coactinon ® nnRTI enfuvirtide, Fuzeon ® FI enteric coated didanosine, Videx EC ® nRTI etravirine, TMC-125 nnRTI fosamprenavir calcium, Lexiva ® PI indinavir, indinavir sulfate, Crixivan ® PI lamivudine, 3TC, Epivir ® nRTI lamivudine + zidovudine, Combivir ® nRTI lopinavir PI lopinavir + ritonavir, Kaletra ® PI maraviroc, Selzentry ® EI nelfinavir, nelfinavir mesylate, Viracept ® PI nevirapine, NVP, Viramune ® nnRTI PPL-100 (also known as PL-462) (Ambrilia) PI raltegravir, MK-0518, Isentress ™ InI rilpivirine nnRTI ritonavir, Norvir ® PI saquinavir, saquinavir mesylate, Invirase ®, Fortovase ® PI stavudine, d4T, didehydrodeoxythymidine, Zerit ® nRTI tipranavir, Aptivus ® PI vicriviroc, vicriviroc maleate EI EI = entry inhibitor; FI = fusion inhibitor; InI = integrase inhibitor; PI = protease inhibitor; nRTI = nucleoside reverse transcriptase inhibitor; nnRTI = non-nucleoside reverse transcriptase inhibitor. Some of the drugs listed in the table are used in a salt form; e.g., abacavir sulfate, delavirdine mesylate, indinavir sulfate, atazanavir sulfate, nelfinavir mesylate, saquinavir mesylate.

It is understood that the scope of combinations of the compounds of this disclosure with anti-HIV agents is not limited to the HIV antivirals listed in Table 1, but includes in principle any combination with any pharmaceutical composition useful for the treatment or prophylaxis of AIDS. The HIV antiviral agents and other agents will typically be employed in these combinations in their conventional dosage ranges and regimens as reported in the art, including, for example, the dosages described in the current Physicians' Desk Reference, Thomson PDR, 70th edition (2016), Montvale, N.J.: PDR Network, or in prior editions thereof. The dosage ranges for a compound of the disclosure in these combinations can be the same as those set forth above.

The compounds of this disclosure are also useful in the preparation and execution of screening assays for antiviral compounds. For example, the compounds of this disclosure can be useful for isolating enzyme mutants, which are excellent screening tools for more powerful antiviral compounds. Furthermore, the compounds of this disclosure can be useful in establishing or determining the binding site of other antivirals to HIV reverse transcriptase, e.g., by competitive inhibition.

Abbreviations and acronyms employed herein include the following:

Ac Acetyl ACN acetonitrile AUC Area under the curve Bu Butyl DBU 1,8-Diazabicyclo[5.4.0]undec-7-ene DCM dichloromethane DIEA or DIPEA or N,N-diisopropylethylamine Hünig's base Et Ethyl EtOH Ethanol e.g. for example g grams GI gastrointenstinal h hour(s) HIV human immunodeficiency virus HPBCD hydroxypropyl β-cyclodextrin HPLC high-performance liquid chromatography Hz hertz IPA isopropanol IV intravenous iPr isopropyl KHMDS Potasium bis(trimethylsilyl)amide L liter LC liquid chromatography LC/MS, LCMS liquid chromatography mass spectrometry LDA Lithium diisopropylamide LiHMDS Lithiuim bis(trimethylsilyl)amide Me methyl mg milligrams nm nanometer(s) MHz megahertz min minute μL microliters mL milliliters mmol millimoles MS mass spectrometry NHS normal human serum NMR nuclear magnetic resonance spectroscopy PBMC peripheral blood mononuclear cell Ph phenyl P.O. oral RT or rt room temperature (ambient, about 25° C.) RP-Flash reverse phase chromatography chromatography SFC supercritical fluid chromatography TLC thin layer chromatography tBu tert-butyl TEA triethylamine (Et₃N) TFA trifluoroacetic acid TFV Tenofovir TFV-MP Tenofovir monophosphate TFV-DP Tenofovir diphosphate THF tetrahydrofuran TMS tetramethylsilane UPLC ultra high pressure liquid chromatography UV ultraviolet UV/VIS ultraviolet/visible

Several methods for preparing the compounds of this disclosure are described in the following Schemes and Examples. Starting materials and intermediates were purchased commercially from common catalog sources or were made using known procedures, or as otherwise illustrated. Some frequently applied routes to the compounds of Formula I are described in in the Schemes that follow. In some cases the order of carrying out the reaction steps in the schemes may be varied to facilitate the reaction or to avoid unwanted reaction products.

Intermediate compounds of Formula S-1 are prepared from (R)-(((1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)phosphonic acid, referred herein as TFV, after treatment with thionyl or oxalyl chloride. Treatment of S-1 in a two-step one-pot condensation reaction with amines of Formulas S-2 and carbon nucleophile S-4 in the presence of a base such as triethylamine, pyridine, tributylamine and diisopropylethyl amine yields the products of Formula S-5 of the present invention. Lithium, sodium and potassium anions of S-4 can be generated treating the protonated precursors with a base such as NaH, LiHMDS, NaHMDS, KHMDS, LDA or n-BuLi. Other S-4 organometallic nucleophiles such as organomagnesium and organozinc compounds can be employed.

Intermediate compounds of Formula S-7 are prepared from TFV, with variably-substituted phenols in a one-step one-pot condensation reaction with 2,2′-dipyridyldisulfide (aldrithiol), triphenylphosphine, and a base, with phenols such as p-chlorophenol and m-cyanophenol. Intermediates of Formula S-8 are obtained by hydrolysis of the corresponding intermediates of Formula S-7 by treatment with water in the presence of a base such as DBU. Finally, treatment of intermediates of Formula S-8 with thionyl or oxalyl chloride followed by addition of the carbon nucleophile S-4 yields the products of Formula S-5 of the present invention.

Reactions sensitive to moisture or air were performed under nitrogen or argon using anhydrous solvents and reagents. The progress of reactions was determined by either analytical thin layer chromatography (TLC) usually performed with E. Merck pre-coated TLC plates, silica gel 60F-254, layer thickness 0.25 mm or liquid chromatography-mass spectrometry (LC/MS).

Typically the analytical LC-MS system used consisted of a Waters ZQ™ platform with electrospray ionization in positive ion detection mode with an Agilent 1100 series HPLC with autosampler. The column was commonly a Waters Xterra MS C18, 3.0×50 mm, 5 μm or a Waters Acquity UPLC® BEH C18 1.0×50 mm, 1.7 μm. The flow rate was 1 mL/min, and the injection volume was 10 μL. UV detection was in the range 210-400 nm. The mobile phase consisted of solvent A (water plus 0.05% TFA) and solvent B (MeCN plus 0.05% TFA) with a gradient of 100% solvent A for 0.7 min changing to 100% solvent B over 3.75 min, maintained for 1.1 min, then reverting to 100% solvent A over 0.2 min.

Preparative HPLC purifications were usually performed using either a mass spectrometry directed system or a non-mass guided system. Usually they were performed on a Waters Chromatography Workstation configured with LC-MS System consisting of: Waters ZQ™ single quad MS system with Electrospray Ionization, Waters 2525 Gradient Pump, Waters 2767 Injecto/Collector, Waters 996 PDA Detector, the MS Conditions of: 150-750 amu, Positive Electrospray, Collection Triggered by MS, and a Waters SUNFIRE® C-18 5 micron, 30 mm (id)×100 mm column. The mobile phases consisted of mixtures of acetonitrile (10-100%) in water containing 0.1% TFA. Flow rates were maintained at 50 mL/min, the injection volume was 1800 μL, and the UV detection range was 210-400 nm. An alternate preparative HPLC system used was a Gilson Workstation consisting of: Gilson GX-281 Injector/Collector, Gilson UV/VIS-155 Detector, Gilson 333 and 334 Pumps, and either a Phenomenex Gemini-NX C-18 5 micron, 50 mm (id)×250 mm column or a Waters XBridge™ C-18 5 micron OBD™, 30 mm (id)×250 mm column. The mobile phases consisted of mixtures of acetonitrile (0-75%) in water containing 5 mmol (NH₄)HCO₃. Flow rates were maintained at 50 mL/min for the Waters Xbridge™ column and 90 mL/min for the Phenomenex Gemini column. The injection volume ranged from 1000-8000 μL, and the UV detection range was 210-400 nm. Mobile phase gradients were optimized for the individual compounds. Reactions performed using microwave irradiation were normally carried out using an Emrys Optimizer manufactured by Personal Chemistry, or an Initiator manufactured by Biotage. Concentration of solutions was carried out on a rotary evaporator under reduced pressure. Flash chromatography was usually performed using either a Biotage® Flash Chromatography apparatus (Dyax Corp.), an ISCO CombiFlash® Rf apparatus, or an ISCO CombiFlash® Companion XL on silica gel (32-63 μM, 60 Å pore size) in pre-packed cartridges of the size noted. ¹H NMR spectra were acquired at 500 MHz spectrometers in CDCl₃ solutions unless otherwise noted. Chemical shifts were reported in parts per million (ppm). Tetramethylsilane (TMS) was used as internal reference in CD₃Cl solutions, and residual CH₃OH peak or TMS was used as internal reference in CD₃OD solutions. Coupling constants (J) were reported in hertz (Hz). Chiral analytical chromatography was most commonly performed on one of CHIRALPAK® AS, CHIRALPAK®AD, CHIRALCEL® OD, CHIRALCEL® IA, or CHIRALCEL® OJ columns (250×4.6 mm) (Daicel Chemical Industries, Ltd.) with noted percentage of either ethanol in hexane (% Et/Hex) or isopropanol in heptane (% IPA/Hep) as isocratic solvent systems. Chiral preparative chromatography was conducted on one of CHIRALPAK AS, of CHIRALPAK AD, CHIRALCEL® OD, CHIRALCEL®IA, CHIRALCEL® OJ columns (20×250 mm) (Daicel Chemical Industries, Ltd.) with desired isocratic solvent systems identified on chiral analytical chromatography or by supercritical fluid (SFC) conditions.

It is understood that a chiral center in a compound may exist in the “S” or “R” stereo-configuration, or as a mixture of both. Within a molecule, each bond drawn as a straight line from a chiral center includes each of the (R) and (5) stereoisomers as well as mixtures thereof.

The compounds of the disclosure herein including those in Examples 1 to 9 contain a phosphorus chiral center. The isomer mixture in each of Examples 2, 3, 6 and 7 were separated, providing an Example #A, e.g., Example 2A, (the faster eluting isomer) and an Example #B, e.g., Example 2B, (the slower eluting isomer), based on their observed elution order resulting from the separation as performed in the Example. Elution time and/or order of separated isomers may differ if performed under conditions different than those employed herein. Absolute stereochemistry (R or 5) of the phosphorus chiral center in each of the “A” and “B” separated stereoisomers in Examples 2, 3, 6 and 7 was not determined, and “A” and “B” only refer to elution order of each isomer. An asterisk (*) may be used in the associated chemical structure drawings of the Example compounds to indicate the phosphorus or other chiral centers.

Intermediate A

Propyl 2-amino-2-methylpropanoate Hydrochloride (Compound 1)

To a solution of 2-amino-2-methylpropanoic acid (10 g, 97 mmol) in propan-1-ol (200 mL, 97 mmol) was added SOCl₂ (28 mL, 388 mmol) at −50° C. Thereafter, the mixture was stirred for 1 h at ambient temperature and then heated to 80° C. for 16 h. Thereafter, the mixture was concentrated under vacuum. Diethyl ether (80 mL) was added to the residue and the mixture was stirred for 0.5 h. The mixture was then filtered and washed with diethyl ether (80 mL) and the filter cake was dried to provide the title compound. LC/MS: [(M+1)]⁺=146.1.

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(4-chlorophenoxy)phosphorylamino)-2-methylpropanoate (Compound 2, Mixture of Two Isomers)

To a solution of propyl 2-amino-2-methylpropanoate hydrochloride (10 g, 59.6 mmol) in pyridine (200 mL) was added 4-chlorophenol (7 g, 59.6 mmol), (R)-(1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methylphosphonic acid (17.2 g, 59.6 mmol), triphenylphosphine (62.6 g, 238 mmol), 1,2-di(pyridin-2-yl)disulfane (52.6 g, 238 mmol), and triethylamine (48.4 g, 478 mmol) at room temperature. The resulting suspension was stirred at 60° C. for 16 h under a nitrogen atmosphere. The reaction solution was monitored by TLC and LCMS. After cooling down to room temperature, the resulting mixture was concentrated under reduced pressure and the residue was purified by silica gel column chromatography, eluted with CH₂C₁₂/CH₃OH=20/1) to give the title compound. LC/MS: [(M+1)]⁺=525.2.

¹HNMR (300 MHz, CDCl₃, ppm): δ 8.31 (d, J=3.0 Hz, 1H), 7.96 (s, 1H), 7.30-7.04 (m, 3H), 6.93-6.83 (m, 1H), 5.75 (s, 2H), 4.36-4.31 (m, 1H), 4.16-3.81 (m, 5H), 3.69-3.59 (m, 1H), 3.11-3.04 (m, 1H), 1.74-1.53 (m, 5H), 1.50-1.29 (m, 6H), 1.22 (m, 3H), 0.91 (m, 3H).

P—(((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic Acid (Intermediate A)

To a solution of propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(4-chlorophenoxy)phosphorylamino)-2-methylpropanoate (10 g, 19.05 mmol) in water (50 mL) and THE (50 mL) was added DBU (4.31 mL, 28.55 mmol) at room temperature. The solution was stirred at room temperature for 1 h. The reaction was concentrated under vacuum. The aqueous phase was purified by RP-Flash chromatography (column: C18 gel column (330 g), 20-35 μm; Mobile Phase: ACN and water (Gradient: 10% hold 10 min, up to 30% within 20 min); Flow rate: 80 mL/min; 254 nm; Rt: 18 min) to give the title compound (contained 1 eq. DBU). LC/MS: [(M+1)]⁺=415.2. ¹H NMR (400 MHz, D₂O, ppm) δ 8.03 (s, 1H), 8.00 (s, 1H), 4.15 (m, 1H), 4.01 (m, 1H), 3.83-3.68 (m, 3H), 2.48-2.40 (m, 2H), 1.44-1.30 (m, 2H), 1.10-0.96 (m, 9H), 0.66 (t, J=6.0 Hz, 3H).

Isopropyl 2-phenylacetate

To a solution of 2-phenylacetic acid (4 g, 29.4 mmol) in propan-2-ol (1.77 g, 29.4 mmol) was added thionyl chloride (5.2 g, 44.1 mmol) at 0° C. The mixture was stirred at 85° C. for 3 h. The resulting mixture was concentrated under vacuum and the residue was purified by silica gel chromatography, eluting with 25% ethyl acetate in petroleum ether to provide the title compound. ¹H NMR (300 MHz, CDCl₃, ppm): δ 7.34-7.22 (m, 5H), 5.08-4.95 (m, 1H), 3.57 (s, 2H), 1.22 (d, J=6.3 Hz, 6H).

Example 1

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(1-cyano-2-isopropoxy-2-oxoethyl)phosphorylamino)-2-methylpropanoate (1) (Mixture of Four Stereoisomers)

To a solution of isopropyl 2-cyanoacetate (1.38 g, 10.86 mmol) in dry THF (7 mL) was added lithium bis(trimethylsilyl)amide (15.2 mL, 15.2 mmol) at 0° C. The reaction solution was stirred at 0° C. for 1 h and this solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (900 mg, 2.17 mmol) in dry acetonitrile (7 mL) was added thionyl chloride (0.48 mL, 6.52 mmol) at 0° C., followed by stirring at 0° C. for 2 h and then the mixture was concentrated under vacuum. The residue was dissolved in THF (2 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. This mixture was stirred at 0° C. for another 1 h. The desired product was detected by LCMS. The mixture was concentrated under vacuum. The crude product was purified by prep-HPLC with the following conditions: Column: Atlantis Prep T3 OBD Column, 19*250 mm; Mobile Phase A: water (10 mmol/NH₄HCO₃), Mobile Phase B: ACN; Flow rate: 20 mL/min; Gradient: 18% B to 40% B in 12 min; 254 nm; RT: 10.27 min. The collected fractions were lyophilized to afford the title compound 1.

¹H NMR (300 MHz, CD₃OD, ppm): δ 8.23 (s, 1H), 8.18 (s, 1H), 4.93-4.82 (m, 1H), 4.55-4.36 (m, 1H), 4.27-3.94 (m, 5H), 3.77-3.51 (m, 2H), 1.63-1.36 (m, 8H), 1.22-1.08 (m, 9H), 0.93-0.82 (m, 3H); ³¹P NMR (121 MHz, CD₃OD, ppm): δ 32.18 (s, 1P), 21.51 (s, 1P); LC/MS: [(M+1)]⁺=524.2.

Example 2

Diisopropyl 2-((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)((2-methyl-1-oxo-1-propoxypropan-2-yl)amino)phosphoryl)malonate, and Diisopropyl 2-((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)((2-methyl-1-oxo-1-propoxypropan-2-yl)amino)phosphoryl)malonate (2A and 2B)

To a solution of diisopropyl malonate (2.50 g, 13.27 mmol) in dry THF (10 mL) was added NaH (0.53 g, 13.27 mmol) at 0° C. The mixture was stirred at room temperature for 0.5 h. This solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (1.10 g, 2.65 mmol) in dry acetonitrile (10 mL) was added thionyl chloride (0.19 mL, 2.65 mmol) at 0° C., followed by stirring at 0° C. for 1 h and concentrated under vacuum. The residue was dissolved in THF (5 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. The resulting mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. The mixture was concentrated under vacuum. The crude product was purified by RP-Flash chromatography (column: C18 gel column (330 g), 20-35 μm; Mobile Phase: ACN and water (gradient: 10% hold 10 min, up to 30% within 20 min); Flow rate: 80 mL/min; 254&220 nm; RT: 18 min) to give a mixture of the two stereoisomers. The mixture of two stereoisomers were separated and further purified by prep-HPLC with the following conditions: (column: X-Bridge C18 OBD Prep column 100*10 um, 19 mm*250 mm; Mobile Phase A: water (10 mmol/L NH₄HCO₃), Mobile Phase B: ACN; Flow rate: 20 mL/min; Gradient: 39% B to 44% B in 9 min; 254 nm), and the collected fractions were lyophilized to afford each stereoisomer 2A and 2B.

Example 2A (faster eluting): ¹HNMR (400 MHz, CD₃OD, ppm): δ 8.23 (s, 1H), 8.17 (s, 1H), 5.06-4.98 (m, 2H), 4.41-4.37 (m, 1H), 4.26-4.16 (m, 2H), 4.09-3.87 (m, 4H), 3.84 (dd, J=12.8, 8.8 Hz, 1H), 1.68-1.63 (m, 2H), 1.47 (d, J=5.2 Hz, 6H), 1.30-1.22 (m, 15H), 0.94 (t, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CD₃OD, ppm): δ 31.467; LC/MS: [(M+1)]⁺=585.3;

Example 2B (slower eluting): ¹HNMR (400 MHz, CD₃OD, ppm): δ 8.23 (s, 1H), 8.18 (s, 1H), 5.04-4.81 (m, 3H), 4.39-4.25 (m, 2H), 4.11-3.95 (m, 5H), 1.70-1.63 (m, 2H), 1.52 (d, J=7.6 Hz, 6H), 1.33-1.20 (m, 15H), 0.96 (t, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CD₃OD, ppm): δ 31.609; LC/MS: [(M+1)]⁺=585.3.

Example 3

Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-isopropoxy-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate, and Propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-isopropoxy-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate (3A and 3B)

To a solution of isopropyl acetate (4.9 g, 48.3 mmol) in THF (60 mL) was added lithium bis(trimethylsilyl) amide (48.3 mL, 48.3 mmol) at −78° C. The mixture was stirred at room temperature for 2 h. This solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (4.0 g, 9.7 mmol) in acetonitrile (60 mL) was added thionyl chloride (5.7 g, 48.3 mmol) at −5° C., followed by stirring at 0° C. for 2 h and concentrated under vacuum. The residue was dissolved in THF (5 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. and this mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. Next, the reaction mixture was concentrated under vacuum and the product was purified by RP-Flash chromatography (column: C18 gel column (330 g), 20-35 μm; Mobile Phase: ACN and water (gradient: 10% hold 10 min, up to 30% within 20 min); flow rate: 80 mL/min; 254&220 nm; RT: 18 min) to give a mixture of two stereoisomers which were separated and purified by chiral-prep-HPLC with the following conditions: (column: CHIRALPAK IF, 2*25 cm, 5 um; Mobile Phase A: Hex, Mobile Phase B: IPA; Flow rate: 13 mL/min; gradient: 50 B to 50 B in 35 min; 220&254 nm; The collected fractions were combined and lyophilized to afford each stereoisomer 3A and 3B.

Example 3A: ¹H NMR (300 MHz, CD₃OD, ppm): δ 8.21 (s, 1H), 8.18 (s, 1H), 4.99-4.78 (m, 2H, 4.42-4.37 (m, 1H), 4.28-4.21 (m, 1H), 4.12-3.94 (m, 4H), 3.67 (dd, J=12.6, 8.4 Hz, 1H), 2.91 (dd, J=16.8, 8.4 Hz, 1H), 1.72-1.44 (m, 8H), 1.28-1.15 (m, 9H), 0.95 (t, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CD₃OD, ppm): δ 33.99; LC/MS: [(M+1)]⁺=499.3.

Example 3B: ¹H NMR (300 MHz, CD₃OD, ppm): δ 8.21 (s, 1H), 8.18 (s, 1H), 4.97-4.91 (m, 1H), 4.41-4.37 (m, 1H), 4.27-4.21 (m, 1H), 4.07-3.94 (m, 4H), 3.67 (dd, J=9.6, 6.6 Hz, 1H), 1.67-1.61 (m, 2H), 1.47 (d, J=2.1 Hz, 6H), 1.26 (d, J=4.8 Hz, 3H), 1.22 (m, 6H), 0.95 (t, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CD₃OD, ppm): δ 33.96; LC/MS: [(M+1)]⁺=499.3.

Example 4

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(cyanomethyl)phosphorylamino)-2-methylpropanoate (4)—(Mixture of Two Stereoisomers)

To a solution of acetonitrile (208 mg, 5.07 mmol) in THE (10 mL) was added n-BuLi (2.03 mL, 5.07 mmol) at −78° C. The mixture was stirred at room temperature for 0.5 h. The solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (700 mg, 1.69 mmol) in acetonitrile (10 mL) was added thionyl chloride (1.01 g, 8.45 mmol) at 0° C. The resulting mixture was stirred at 0° C. for 2 h and then concentrated under vacuum. The residue was dissolved in THF (10 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. and the mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. Next, the reaction mixture was concentrated under vacuum and the residue was purified by RP-Flash chromatography with the following conditions: (column: C18 gel column (330 g), 20-35 um; Mobile Phase: ACN and water (gradient: 10% hold 10 min, up to 30% within 20 min); flow rate: 80 mL/min; 254&220 nm; RT: 25 min) to give the crude product. The crude product 4 was further purified by prep-HPLC with the following conditions: column: XBridge C18 OBD Prep Column 100 Å, 10 μm, 19 mm*250 mm; Mobile Phase A: water (10 mmol/L NH₄HCO₃), Mobile Phase B: ACN; flow rate: 20 mL/min; gradient: 10% B to 45% B in 9 min; 254&210 nm; RT: 6.32 min. The collected fractions were combined and lyophilized to afford the title product 4.

¹H NMR (400 MHz, DMSO-d₆ ppm) δ 8.13 (s, 1H), 8.01 (s, 1H), 5.27 (s, 1H), 4.19-3.99 (m, 4H), 3.92-3.88 (m, 1H), 3.60-3.54 (m, 1H), 3.37-3.31 (m, 1H), 1.77-1.68 (m, 2H), 1.38 (s, 3H), 1.16 (s, 3H), 1.02 (d, J=6.4 Hz, 3H), 0.96-0.92 (m, 3H); ³¹P NMR (162 MHz; DMSO-d₆, ppm): δ 13.81; LC/MS: [(M+1)]⁺=438.2.

Example 5

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(2-isopropoxy-2-oxo-1-phenylethyl)phosphorylamino)-2-methylpropanoate (5) (Mixture of Four Stereoisomers)

To a solution of isopropyl 2-phenylacetate (215 mg, 1.21 mmol) in THF (5 mL) was added potassium bis(trimethylsilyl) amide (1.21 mL, 1.21 mmol) at −78° C. The solution was then stirred at room temperature for 0.5 h. This reaction solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl) propan-2-yl)oxy) methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (100 mg, 0.24 mmol) in acetonitrile (5 mL) was added thionyl chloride (0.12 mL, 1.69 mmol) at 0° C. The mixture was stirred at room temperature for 5 h and then concentrated under vacuum. The residue was dissolved in THF (5 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. and the mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. Next, the mixture was concentrated under vacuum. The crude product 5 was purified by prep-HPLC with the following conditions: (column: XBridge Prep Phenyl OBD 19×150 mm, 5 um, 13 nm; Mobile Phase A: water, Mobile Phase B: ACN; Flow rate: 20 mL/min; gradient: 25% B to 60% B in 8 min; 254 nm; RT: 5.5 min). The collected fractions were combined and lyophilized to afford the title product 5.

¹H NMR (400 MHz, CD₃OD, ppm): δ 8.17 (s, 1H), 8.08, 7.99 (2s, 1H), 7.40-7.34 (m, 2H), 7.22-7.17 (m, 2H), 7.07-7.05 (m, 1H), 5.07, 5.01 (2s, 1H), 4.43-4.31 (m, 2H), 4.22-4.15 (m, 1H), 4.09-3.95 (m, 4H), 4.83-4.75 (m, 1H), 1.67-1.59 (m, 2H), 1.50-1.26 (m, 12H), 1.22 (d, J=6.0 Hz, 3H), 0.95-0.89 (m, 3H); ³¹P NMR (121 MHz, CD₃OD, ppm): δ 23.12, 22.99; LC/MS: [(M+1)]⁺=575.8.

Example 6

Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(dicyanomethyl)phosphoryl)amino)-2-methylpropanoate, and Propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(dicyanomethyl)phosphoryl)amino)-2-methylpropanoate (6A and 6B)

To a solution of malononitrile in THF (10 mL) was added lithium bis(trimethylsilyl)amide (848 mg, 5.07 mmol) at −78° C. The solution was stirred at room temperature for 0.5 h. This reaction solution was marked as Solution A.

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (300 mg, 0.72 mmol) in acetonitrile (10 mL) was added thionyl chloride (431 mg, 3.62 mmol) at 0° C. followed by stirring at 0° C. for 2 h and concentrated under vacuum. The residue was dissolved in THF (5 mL) and this solution was marked as Solution B. Solution A was added to Solution B at 0° C. and the resulting mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. The mixture was concentrated under vacuum and the residue was purified by RP-flash chromatography with the following conditions: (column: C18 gel column (330 g), 20-35 μm; mobile phase: ACN and water (gradient: 10% hold 10 min, up to 50% within 40 min); flow rate: 80 mL/min; 254&220 nm; RT: 45 min) to give a mixture of the two stereoisomers. The mixture of two stereoisomers was purified by prep-HPLC (column: XBridge C18 OBD prep column 100, 10 μm, 19 mm*250 mm; Mobile Phase A: water (10 mmol/L NH₄HCO₃), Mobile Phase B: ACN; flow rate: 20 mL/min; gradient: 18% B to 20% B in 9 min; 254/210 nm. The collected fractions were combined and lyophilized to afford each stereoisomer 6A and 6B. The faster eluting isomer 6A was further purified with the following conditions: (column: XBridge Shield RP18 OBD column 10 μm, 19 mm*250 mm; Mobile Phase A: Water (0.05% TFA), Mobile Phase B: ACN; flow rate: 20 mL/min; Gradient: 15% B to 30% B in 9 min; 254&210 nm; RT: 7.70 min).

Example 6A (faster eluting): (300 MHz, CD₃OD, ppm) δ 8.47 (s, 1H), 8.35 (s, 1H), 4.53-4.37 (m, 1H), 4.37-4.30 (m, 1H), 4.24-4.20 (t, J=6.6 Hz, 1H), 4.10-4.02 (m, 2H), 3.86-3.80 (m, 1H), 3.61-3.54 (m, 1H), 3.32-3.20 (m, 1H), 1.77-1.61 (m, 2H), 1.58-1.53 (m, 6H), 1.25 (d, J=6.3 Hz, 3H), 0.99-0.93 (m, 3H); ³¹P NMR (162 MHz, CD₃OD, ppm) δ 33.04; LC/MS: [(M+1)]⁺=463.2; and

Example 6B (slower eluting): (300 MHz, CD₃OD, ppm) δ 8.28 (s, 1H), 8.18 (s, 1H), 4.43-4.37 (m, 1H), 4.29-4.22 (m, 1H), 4.06 (t, J=6.6 HZ, 2H), 3.98-3.93 (m, 1H), 3.80-3.73 (m, 1H), 3.59-3.53 (m, 1H), 1.70-1.61 (m, 2H), 1.55 (d, J=8.1 Hz, 6H), 1.16 (d, J=6.3 Hz, 3H), 0.92 (t, J=7.2 HZ, 3H); ³¹P NMR (162 MHz, CD₃OD) δ 32.81; LC/MS: [(M+1)]⁺=463.2.

Example 7

Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-(diethylamino)-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate, and propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-(diethyl amino)-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate (7A and 7B)

To a solution of N,N-diethylacetamide (0.93 mg, 8.09 mmol) in THF (20 mL) was added LiHMDS (1.35 mg, 8.09 mmol) at −78° C. The mixture was stirred for 1 h at −78° C. The reaction solution was marked as Solution A.

To a stirred solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (500 mg, 1.21 mmol) in acetonitrile (20 mL) was added thionyl chloride (0.44 mL, 6.03 mmol) at 0° C. The mixture was stirred for 1 h at 0° C. and then concentrated under vacuum. The residue was dissolved in THF (5 mL) and this solution was marked as Solution B. Solution A was added to Solution B at −78° C. and the mixture was stirred for 2 h at −78° C. and then warmed to ambient temperature. After the reaction was completed (monitored by LCMS), the desired product was detected. The mixture was quenched with saturated aqueous of NH₄Cl (10 mL) and extracted with CHCl₃ (3×50 mL). The combined organic layers were washed with brine (3×30 mL), dried with anhydrous sodium sulfate and filtered. The filtrate was concentrated under reduced pressure and the residue was purified by prep-HPLC (column: XBridge C18 OBD Prep Column 100 Å, 10 μm, 19 mm×250 mm; Mobile Phase A: water, Mobile Phase B: ACN; flow rate: 20 mL/min; gradient: 20% B to 60% B in 9 min; 254/210 nm; RT: 6.54 min) to afford a mixture of the two stereoisomers which were separated and purified by Prep-Chiral-HPLC (Column: CHIRALPAK IG, 20*250 mm, 5 um; Mobile Phase A: hexanes:DCM=3:1, Mobile Phase B: EtOH; flow rate: 19 mL/min; gradient: 50 B to 50 B in 15 min; 220/254 nm) to afford stereoisomers 7A and 7B.

Example 7A (faster eluting): ¹H NMR (400 MHz, CDCl₃, ppm): δ 8.34 (s, 1H), 7.96 (s, 1H), 5.91 (s, 2H), 4.40-4.36 (m, 1H), 4.16-4.10 (m, 1H), 3.98-3.91 (m, 4H), 3.83-3.78 (m, 2H), 3.47-3.27 (m, 5H), 1.69-1.63 (m, 2H), 1.45 (s, 3H), 1.44 (s, 3H), 1.30-1.12 (m, 9H), 0.93 (t, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CDCl₃, ppm): δ 23.70; LC/MS: [(M+1)]⁺=512.3.

Example 7B (slower eluting): ¹H NMR (400 MHz, CDCl₃, ppm): δ 8.35 (s, 1H), 7.99 (s, 1H), 5.81 (s, 2H), 4.38-4.34 (m, 1H), 4.15-4.09 (m, 1H), 4.03 (d, J=9.6 Hz, 1H), 3.92-3.72 (m, 5H), 3.55-3.28 (m, 5H), 1.58-1.49 (m, 8H), 1.30-1.11 (m, 9H), 0.85 (m, J=7.4 Hz, 3H); ³¹P NMR (162 MHz; CDCl₃, ppm) δ 24.10; LC/MS: [(M+1)]⁺=512.3.

Example 8

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(2-tert-butoxy-2-oxoethyl)phosphoryl amino)-2-methylpropanoate (8) (Mixture of Two Stereoisomers)

To a solution of tert-butyl acetate (1.40 g, 12.07 mmol) in THF (50 mL) was added LiHMDS (2.02 g, 12.07 mmol) at −78° C. The mixture was stirred at −78° C. for 1 h and marked as Solution A

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl)phosphonamidic acid (1 g, 2.41 mmol) in acetonitrile (50 mL) was added thionyl chloride (2.01 g, 16.89 mmol) at 0° C. The mixture was stirred at 0° C. for 2 h, then the mixture was concentrated under vacuum and the residue was dissolved in THF (10 mL). This solution was marked as Solution B. Solution A was added to Solution B at 0° C. and the resulting mixture was stirred at 0° C. for 1 h. The desired product was detected by LCMS. The mixture was concentrated under reduced pressure and the residue was purified by RP-Flash chromatography (column: C18 gel column (330 g), 20-35 μm; Mobile Phase: ACN and water (gradient: 10% hold 10 min, up to 30% within 20 min); flow rate: 80 mL/min; 254&220 nm; RT: 18 min) to give crude product 8. The compound was further purified by column: XBridge C18 Column, 5 um, 19×250 mm; Mobile Phase A: water (10 mmol/L NH₄HCO₃), Mobile Phase B: ACN; flow rate: 20 mL/min; gradient: 30% B to 80% B in 10 min; 254 nm; RT: 6.13 min to afford the title product 8.

¹H NMR (300 MHz, CD₃OD, ppm): δ 8.21 (s, 1H), 8.19 (s, 1H), 4.41-4.37 (m, 1H), 4.27-4.21 (m, 1H), 4.12-3.90 (m, 4H), 3.74-3.62 (m, 1H), 2.87-2.67 (m, 2H), 1.72-1.62 (m, 2H), 1.52-1.41 (m, 15H), 1.37-1.26 (m, 3H), 0.99-0.92 (m, 3H); ³¹P NMR (121 MHz, CD₃OD, ppm): δ 34.19; LC/MS: [(M+1)]⁺=513.3.

Example 9

Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(benzyl)phosphorylamino)-2-methylpropanoate (9) (Mixture of Two Stereoisomers)

To a solution of P—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)-N-(2-methyl-1-oxo-1-propoxypropan-2-yl) phosphonamidic acid (1 g, 2.41 mmol) in acetonitrile (10 mL) was added SOCl₂ (1.23 mL, 16.89 mmol) at 0° C. The mixture was stirred at 0° C. for 2 h, then the mixture was concentrated under vacuum and the residue was dissolved in THE (10 mL). Benzylmagnesium bromide (24.13 ml, 24.13 mmol) was added at −78° C. and the mixture was stirred at 0° C. for 2 h. The desired product was detected by LCMS. The mixture was concentrated under reduced pressure and the residue was purified by RP-Flash chromatography (column: C18 gel column (330 g), 20-35 μm; Mobile Phase: ACN and water (gradient: 10% hold 10 min, up to 30% within 20 min); flow rate: 80 mL/min; 254 & 220 nm; RT: 18 min) to give the crude product 9. The compound was further purified by Prep-HPLC (Column: XBridge Prep Phenyl OBD Column 19×150 mm, 5 um, 13 nm; Mobile Phase A: Water, Mobile Phase B: ACN; flow rate: 20 mL/min; Gradient: 20% B to 80% B in 8 min; 254 nm; RT: 7.65 min.) to afford the title compound 9.

¹H NMR (400 MHz, CDCl₃, ppm): δ 8.39, 8.36 (2s, 1H), 7.99, 7.91 (2s, 1H), 7.26-6.90 (m, 5H), 5.64 (s, 2H), 4.36-4.32 (m, 1H), 4.19-4.08 (m, 3H), 3.95-3.82 (m, 1H), 3.67-3.54 (m, 2H), 3.28-3.24 (m, 1H), 3.15-2.72 (m, 2H), 1.73-1.41 (m, 8H), 1.25-1.20 (m, 3H), 0.98-0.92 (m, 3H); ³¹P NMR (121 MHz, CDCl₃, ppm): δ 34.59, 34.32; LC/MS: [(M+1)]⁺=489.3.

Example 10

Assessing Antiviral Potency in a Human PBMC Based HIV-1 Replication Assay

The antiviral activity of the tenofovir prodrugs of the Examples herein was assessed in a human peripheral blood mononuclear cell (PBMC) based HIV-1 replication assay and performed as follows. Human PBMCs were treated with PHA (5 mg/ml) in RPMI 1640 medium containing 10% heat inactivated FBS for 2 to 3 days. Compound plates were prepared by dispensing compounds dissolved in DMSO into wells of 384 well poly-D-lysine-coated plates (0.2 μl/well) using an ECHO acoustic dispenser. Each compound was tested in a 10-point serial 3-fold dilution (typical final concentrations: 5.0 μM-0.1 nM). Controls included no inhibitor (DMSO only) and a combination of three antiviral agents (efavirenz, indinavir, an in-house integrase strand transfer inhibitor at final concentrations of 4 μM each). PHA-activated human PBMCs were added to the compound plates and incubated for 24 hours at 37° C./5% CO₂/90% relative humidity. The PBMCs were then infected with an HIV-1 construct that encodes Green Fluorescence Protein (GFP) and the infected cells were incubated at 37° C./5% CO₂/90% relative humidity for additional 24 hours.

Infected cells were quantified by counting the number of green cells in each well using an Acumen eX3 scanner. IC₅₀ values were determined by non-linear 4-parameter curve fitting. IC₅₀ values are shown in Table 2.

Example 11

Prodrug Stability Assay in Bio-Relevant Media

The following assay was employed to evaluate the stability of the prodrugs in simulated gastrointestinal tract conditions. Preparation of fasted state simulated intestinal fluid (FaSSIF) using Phares SIF Powder was carried out according to protocols from Phare Drug Delivery AG (Baselland, Switzerland). For sample preparation, 10 μL stock solutions (10 mM) of prodrug substance in DMSO was added to 990 μL of 0.5 mg/mL Pancreatin solution (Fisher CAS #8049-47-6) in FaSSIF. Two samples were prepared for each compound. If the sample was a clear solution, it was directly analyzed by HPLC. If the sample was not clear, the sample was diluted with 100% MeCN, maintained at 37° C. and observed 5 h later. If the sample was clear, HPLC analysis was directly performed. If the sample was still not clear, the sample was diluted with 100% ACN and assayed by HPLC. All the samples were vortexed for 3 min and observed before injection. For the diluted samples, the area is multiplied by a dilution factor when the data is analyzed. The analysis was carried out with an Agilent 1100 series HPLC with autosampler. The column was a Poroshell 120 EC-C18, 4.6×50 mm, 2.7 μm. The flow rate was 1.8 mL/min, and the injection volume was 5 or 10 μL. UV detection was in the range 210-400 nm. The mobile phase consisted of solvent A (water plus 10 mM tetrabutylammonium bromide) and solvent B (acetonitrile) with a gradient of: 90% solvent A at 0 min, changing to 95% solvent B over 6 min, maintaining for 1.5 min, then reverting to 90% solvent A over 1.6 min. The HPLC peak area of the prodrug at 5 h was divided by the HPLC peak area of the prodrug at 0 h, to generate the % claimed parent ratio, which is summarized in Table 2 for gastrointestinal (GI) Tract stability.

TABLE 2 Example PBMC, IC₅₀ (nM) GI Tract stability (%) 1 1522 2A 73.9 2B 6.8 87.2 3A 189 3B 226 4 >2101 5 58.8 6A >2101 6B >2101 7A 931 7B >2101 8 >2101 9 964.7 

What is claimed is:
 1. A compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein: R¹ is (a) —C₁₋₄alkyl, (b) —C₁₋₄alkyl substituted with —OH, —SH, —SCH₃, —NH₂, —NH—C(═NH)—NH₂, (c) —CH₂-phenyl, (d) —CH₂-phenol, (e) —(CH₂)₁₋₂—COOH, (f) —(CH₂)₁₋₂—CONH₂, (g) —CH₂-1H-indole, (h) —CH₂-imidazole, (i) aryl or (j) heteroaryl; R² is (a) —C₁₋₄alkyl, (b) —C₁₋₄alkyl substituted with —OH, —SH, —SCH₃, —NH₂, —NH—C(═NH)—NH₂, (c) —CH₂-phenyl, (d) —CH₂-phenol, (e) —(CH₂)₁₋₂—COOH, —(CH₂)₁₋₂—CONH₂, (g) —CH₂-1H-indole, (h) —CH₂-imidazole, (i) aryl or (j) heteroaryl; or R¹ and R² are joined together with the carbon to which they are both attached to form —C₃₋₆cycloalkyl or a 4 to 6-membered heterocyclic ring; R³ is —CN, —CF₃, phenyl, heteroaryl, —C(O)OR^(5b), —C(O)—N(R^(6a)) (R^(6b)), —S(O)₂R^(5b) or —S(O)₂—N(R^(6a))(R^(6b)), wherein each of phenyl and heteroaryl is unsubstituted or substituted with one to three substituents independently selected at each occurrence from R¹⁰; R⁴ is —H, —CN, —CF₃, phenyl, heteroaryl, —C(O)OR^(5c) or —C(O)—N(R^(6c))(R^(6d)), —S(O)₂R^(5c) or —S(O)₂—N(R^(6c))(R^(6d)), wherein each of phenyl and heteroaryl is unsubstituted or substituted with one to three substituents independently selected at each occurrence from R¹⁰; R^(5a), R^(5b) and R_(5c) are each independently: (a) —C₁₋₁₀alkyl unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —CN, —CF₃, —NR^(7a)R^(7b), —OR⁸, —SH, —C₃₋₆cycloalkyl or spiro-C₃₋₆cycloalkyl, (b) —CH₂-phenyl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected at each occurrence from R¹⁰, (c) —C₃₋₈ cycloalkyl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected at each occurrence from R¹⁰, (d) aryl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected at each occurrence from R¹⁰, (e) —C₁₋₅ alkyl-X—C₁₋₅ alkyl wherein X is O, S or NH, (f) heteroaryl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected at each occurrence from R¹⁰, or (g) a heterocyclic ring unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected at each occurrence from R¹⁰; R^(6a), R^(6b), R^(6c) and R^(6d) are each independently —H, —C₁₋₃alkyl or —C₃₋₆cycloalkyl; R^(7a) and R^(7b) are each independently —H, —C₁₋₃alkyl or —C₃₋₆cycloalkyl; R⁸ is —H or —C₃₋₆cycloalkyl; and R⁹ is —H, —C₁₋₃alkyl or —C₃₋₆cycloalkyl; and R¹⁰ is fluoro, chloro, bromo, —CN, —CF₃, —NR^(7a)R^(7b), —OR⁹, —SH or —C₁₋₃alkyl.
 2. The compound of claim 1, or a pharmaceutically acceptable salt thereof, wherein R¹ and R² are both the same and are selected from methyl, ethyl, propyl or i-propyl.
 3. The compound of claim 1, or a pharmaceutically acceptable salt thereof, wherein R¹ and R² are both methyl.
 4. The compound of claim 2, or a pharmaceutically acceptable salt thereof, wherein R³ is (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH, —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or —CH₂CH₂CF₃; (b) —CH₂-phenyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, (d) phenyl or naphthyl, each unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, (e) —CH₂CH₂OCH₃, —CH₂CH₂CH₂OCH₃, —CH₂CH₂SCH₃, —CH₂CH₂CH₂SCH₃, —CH₂CH₂NHCH₃, —CH₂CH₂CH₂NHCH₃, (f) pyridyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl, or (g) piperidinyl, pyrrolidinyl, tetrahydrofuranyl, or tetrahydropyranyl, each unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl.
 5. The compound of claim 4, or a pharmaceutically acceptable salt thereof, wherein R⁴ is (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH, —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or —CH₂CH₂CF₃; (b) —CH₂-phenyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, (d) phenyl or naphthyl, each unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, (e) —CH₂CH₂OCH₃, —CH₂CH₂CH₂OCH₃, —CH₂CH₂SCH₃, —CH₂CH₂CH₂SCH₃, —CH₂CH₂NHCH₃, —CH₂CH₂CH₂NHCH₃, (f) pyridyl, unsubstituted or substituted with one to three substituents independently, wherein each substituent is independently from fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, or (g) piperidinyl, pyrrolidinyl, tetrahydrofuranyl, or tetrahydropyranyl, each unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl.
 6. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein R³ is: (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH, —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or —CH₂CH₂CF₃; (b) —CH₂-phenyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NNR⁶R⁷ or —C₁₋₃alkyl, or (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8a), —SH, —NR⁶R⁷ or —C₁₋₃alkyl; and R⁴ is: (a) —C₁₋₈alkyl, —CH₂CH₂OH, —CH₂CH₂CH₂OH, —CH₂CH₂SH, —CH₂CH₂CH₂SH, —CH₂CH₂NH₂, —CH₂CH₂CH₂NH₂, —CH₂CF₂CH₃ or —CH₂CH₂CF₃; (b) —CH₂-phenyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl, or (c) —C₃₋₆cycloalkyl, unsubstituted or substituted with one to three substituents, wherein each substituent is independently fluoro, chloro, bromo, —OR^(8b), —SH, —NR⁹R¹⁰ or —C₁₋₃alkyl.
 7. The compound of claim 2, or a pharmaceutically acceptable salt thereof, wherein: R³ is —CN, unsubstituted or substituted phenyl, —C(O)OR^(5b) or —C(O)—N(R^(6a))(R^(6b)); and R⁴ is —H, —CN, unsubstituted or substituted phenyl, —C(O)OR^(5c) or —C(O)—N(R^(6c))(R^(6d)).
 8. The compound of claim 7, or a pharmaceutically acceptable salt thereof, wherein: R^(5a), R^(5b) and R^(5c) are each independently —C₁₋₁₀alkyl unsubstituted or substituted with one to three substituents, wherein each substituent is independently selected from fluoro, chloro, bromo, —CN, —CF₃, —NR^(7a)R^(7b), —OR^(8a), —SH, —C₃₋₆cycloalkyl or spiro-C₃₋₆cycloalkyl; and R^(6a), R^(6b), R^(6c) and R^(6d) are each —C₁₋₆ alkyl.
 9. The compound of claim 7, or a pharmaceutically acceptable salt thereof, wherein R^(5a), R^(5b) and R_(5c) are each —C₁₋₆ alkyl.
 10. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein: R¹ and R² are both methyl, R³ is —CN, phenyl, —C(O)OR^(5b) or —C(O)—N(R^(6a))(R^(6b)); R⁴ is —H, —CN, phenyl, —C(O)OR^(5c) or —C(O)—N(R^(6c))(R^(6d)); each of R^(5a), R^(5b) and R^(5c) is —C₁₋₆ alkyl; and each of R^(6a), R^(6b), R^(6c) and R^(6d) is —C₁₋₆ alkyl.
 11. The compound of claim 1 that is: Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(1-cyano-2-isopropoxy-2-oxoethyl)phosphorylamino)-2-methylpropanoate; Diisopropyl 2-((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)((2-methyl-1-oxo-1-propoxypropan-2-yl)amino)phosphoryl)malonate; Diisopropyl 2-((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)((2-methyl-1-oxo-1-propoxypropan-2-yl)amino)phosphoryl)malonate; Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-isopropoxy-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate; Propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-isopropoxy-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate; Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(cyanomethyl)phosphorylamino)-2-methylpropanoate; Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-isopropoxy-2-oxo-1-phenylethyl)phosphorylamino)-2-methylpropanoate; Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(dicyanomethyl)phosphoryl)amino)-2-methylpropanoate; Propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(dicyanomethyl)phosphoryl)amino)-2-methylpropanoate; Propyl 2-(((R)—((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-(diethylamino)-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate; propyl 2-(((R)—((((S)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-(diethylamino)-2-oxoethyl)phosphoryl)amino)-2-methylpropanoate; Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yl)oxy)methyl)(2-tert-butoxy-2-oxoethyl)phosphorylamino)-2-methylpropanoate; Propyl 2-((((R)-1-(6-amino-9H-purin-9-yl)propan-2-yloxy)methyl)(benzyl)phosphorylamino)-2-methylpropanoate; or a pharmaceutically acceptable salt thereof.
 12. A pharmaceutical composition comprising an effective amount of the compound according to any one of claim 1, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
 13. The pharmaceutical composition of claim 12 further comprising an effective amount of one or more additional HIV antiviral agents selected from HIV protease inhibitors, HIV integrase inhibitors, non-nucleoside HIV reverse transcriptase inhibitors, nucleoside HIV reverse transcriptase inhibitors, HIV fusion inhibitors and HIV entry inhibitors.
 14. The pharmaceutical composition of claim 12 further comprising an effective amount of one or more additional HIV antiviral agents selected from: abacavir, abacavir sulfate, abacavir+lamivudine, abacavir+lamivudine+zidovudine, amprenavir, atazanavir, atazanavir sulfate, AZT, capravirine, darunavir, dideoxycytidine, dideoxyinosine, delavirdine, delavirdine mesylate, dolutegravir, doravirine, efavirenz, 4′-ethynyl-2-fluoro-2′-deoxyadenosine, elvitegravir, emtricitabine, emivirine, enfuvirtide, etravirine, fosamprenavir calcium, indinavir, indinavir sulfate, lamivudine, lamivudine+zidovudine, lopinavir, lopinavir+ritonavir, maraviroc, nelfinavir, nelfinavir mesylate, nevirapine, PPL-100, raltegravir, rilpivirine, ritonavir, saquinavir, saquinavir mesylate, stavudine, tipranavir, or vicriviroc.
 15. A method for the treatment of an infection by HIV in a subject in need thereof which comprises administering to the subject an effective amount of the compound according to claim 1, or a pharmaceutically acceptable salt thereof.
 16. The method of claim 15 further comprising administering to the subject an effective amount of one or more additional HIV antiviral agents selected from HIV protease inhibitors, HIV integrase inhibitors, non-nucleoside HIV reverse transcriptase inhibitors, nucleoside HIV reverse transcriptase inhibitors, HIV fusion inhibitors and HIV entry inhibitors.
 17. The method of claim 15 further comprising administering to the subject an effective amount of one or more additional HIV antiviral agents selected from: abacavir, abacavir sulfate, abacavir+lamivudine, abacavir+lamivudine+zidovudine, amprenavir, atazanavir, atazanavir sulfate, AZT, capravirine, darunavir, dideoxycytidine, dideoxyinosine, delavirdine, delavirdine mesylate, dolutegravir, doravirine, efavirenz, 4′-ethynyl-2-fluoro-2′-deoxyadenosine, elvitegravir, emtricitabine, emivirine, enfuvirtide, etravirine, fosamprenavir calcium, indinavir, indinavir sulfate, lamivudine, lamivudine+zidovudine, lopinavir, lopinavir+ritonavir, maraviroc, nelfinavir, nelfinavir mesylate, nevirapine, PPL-100, raltegravir, rilpivirine, ritonavir, saquinavir, saquinavir mesylate, stavudine, tipranavir, or vicriviroc.
 18. The method of claim 15 wherein the subject is human. 